内脏脂肪指数对腹腔镜结直肠癌根治术围手术期疗效的影响

Z. Dahong, Y. Qiang, Lv Quan, Xiang Zheng
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摘要

目的:探讨内脏脂肪指数(VAI)对大肠癌根治术后围手术期的影响,并分析VAI与术后并发症的关系。同时,我们还讨论了VAI与并发症的相关性是否优于体重指数(BMI)、腰围(WC)、甘油三酯(TG)、高密度脂蛋白(HDL)等常见体脂指标。方法:收集重庆医科大学第一附属医院胃肠外科于2021年10月至2022年6月收治的178例结直肠癌患者。通过术前体格检查和血液检查获得患者各项指标。VAI值采用公式计算,由于具有高甘油三酯-腰围表型(腰围增大和高甘油三酯血症)和内脏脂肪指数(VAI,根据腰围、体重指数、甘油三酯和高密度脂蛋白胆固醇评估),被认为是内脏(腹内)肥胖和代谢紊乱的廉价而有效的标志物。然后根据二分法进行分组。由于脏器指数分级共分为30个等级,按分级分为高VAI值组(VAI分级大于15个等级)和低VAI组(不大于4个等级),高VAI组89例;低VAI组89例。采用统计学方法探讨VAI值与患者术后并发症的关系,并进一步分析其是否优于其他体脂指标。结果:178例患者符合纳入标准,按二分类分为高VAI组89例和低VAI组89例。VAI值高的患者手术时间明显延长(213.01±63.67 vs 190.34±68.69 p=0.02),肿瘤N分期较高(p=0.04)。ROC曲线结果显示,VAI值曲线下面积大于BMI、腰围、甘油三酯和高密度脂蛋白,提示VAI值在诊断中的价值更高。结论:VAI升高可延长大肠癌根治性手术患者的手术时间,影响术后机体的恢复,并增加并发症的发生风险。同时,与BMI、腰围、甘油三酯、高密度脂蛋白等指标相比,VAI对并发症的预测效果更好,可在临床工作中推广。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Visceral Fat Index on Perioperative Efficacy of Laparoscopic Radical Resection for Colorectal Cancer
Purpose: To investigate the effect of visceral fat index (VAI) on perioperative period after radical resection of colorectal cancer, and analyze the relationship between VAI and postoperative complications. At the same time, we also discussed whether the correlation between VAI and complications is superior to body mass index (BMI), waist circumference (WC), triglyceride (TG), high-density lipoprotein (HDL) and other common body fat indicators. Methods: From October 2021 to June 2022, 178 colorectal cancer patients in the Gastrointestinal Surgery Department of the First Affiliated Hospital of Chongqing Medical University were collected. Various indexes of patients were obtained through preoperative physical examination and blood examination. VAI value was calculated by formula, because of the high triglyceride-waist-circumference phenotype (increased waist circumference and hypertriglyceridemia) and visceral fat index (Vai, assessed according to waist circumference, body mass index, triglyceride and high-density lipoprotein cholesterol) , it is considered a cheap and effective marker for visceral (intra-abdominal) obesity and metabolic disorders. and then divided into groups according to dichotomy. Because the visceral index grade was divided into a total of 30 grades, according to grade, into the high VAI value group (VAI grade more than 15 grades) and the low VAI group (no more than 4 grades), with 89 patients in the high VAI group; There were 89 patients in the low VAI group. The relationship between VAI value and postoperative complications of patients was discussed by using statistical methods, and whether it was better than other body fat indexes was further analyzed. Results: 178 patients met the inclusion criteria and were divided into 89 patients in the high VAI group and 89 patients in the low VAI group according to the dichotomy. In patients with high VAI value, the operation time was significantly prolonged (213.01 ± 63.67 vs 190.34 ± 68.69 p=0.02), and the tumor N stage was higher (p=0.04). The results of ROC curve revealed that the area under the curve of VAI value was larger than that of BMI, waist circumference, triglyceride and high-density lipoprotein, suggesting that the value of VAI value was higher in diagnosis. Conclusions: The increase of VAI can prolong the operation time of colorectal cancer patients undergoing radical surgery, affect the recovery of the body after surgery, and increase the risk of complications. At the same time, compared with BMI, waist circumference, triglyceride and high-density lipoprotein, VAI has a better prediction effect on complications, which can be popularized in clinical work.
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