Trond Sand , Arnstein Grøtting , Martin Uglem , Nils Augestad , Gjermund Johnsen , Jorunn Sandvik
{"title":"治疗重度肥胖症的 Roux-en-Y 胃旁路术后 10-15 年的神经病变:社区控制神经传导研究","authors":"Trond Sand , Arnstein Grøtting , Martin Uglem , Nils Augestad , Gjermund Johnsen , Jorunn Sandvik","doi":"10.1016/j.cnp.2024.03.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>We searched for long-term peripheral nerve complications 10–15 years after Roux-en-Y gastric bypass surgery (RYGB), using a comprehensive nerve conduction study (NCS) protocol.</p></div><div><h3>Methods</h3><p>Patients (n = 175, mean age 52.0, BMI 35.2) and 86 community-controls (mean age 56.8, BMI 27.2) had NCS of one upper and lower limb. New abnormality scores from 27 polyneuropathy-relevant (PNP27s) and four carpal tunnel syndrome-relevant NCS-measures (CTS4s) were compared between groups with non-parametric statistics. Estimated prevalences were compared by 95 % confidence limits. The clinical neurophysiologist’s diagnosis was retrieved from hospital records (PNP-ncs, CTS-ncs, other).</p></div><div><h3>Results</h3><p>Abnormality score did not differ between RYGB and control groups (PNP27s: 1.9 vs 1.7, CTS4s: 0.7 vs 0.6, p > 0.29). BMI correlated weakly with CTS4s in patients (rho = 0.19, p = 0.01), and less with PNP27s (rho = 0.12, p = 0.12). Polyneuropathy (PNP-ncs) prevalence was 12 % in patients and 8 % in controls. CTS-ncs prevalence was 21 % in patients and 10 % in controls (p = 0.04).</p></div><div><h3>Conclusions</h3><p>NCS-based abnormality scores did not differ between patients 10–15 years after RYGB and community-recruited controls, neither for PNP nor CTS.</p></div><div><h3>Significance</h3><p>Long-term polyneuropathic complications from RYGB have probably been avoided by modern treatment guidelines. NCS-diagnosed CTS is common in overweight RYGB patients. RYGB-patients with significant neuropathic symptoms need clinical evaluation.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"9 ","pages":"Pages 130-137"},"PeriodicalIF":2.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X24000131/pdfft?md5=77668f9eb607ec5ad7bd32c24c90f7c5&pid=1-s2.0-S2467981X24000131-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Neuropathy 10–15 years after Roux-en-Y gastric bypass for severe obesity: A community-controlled nerve conduction study\",\"authors\":\"Trond Sand , Arnstein Grøtting , Martin Uglem , Nils Augestad , Gjermund Johnsen , Jorunn Sandvik\",\"doi\":\"10.1016/j.cnp.2024.03.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>We searched for long-term peripheral nerve complications 10–15 years after Roux-en-Y gastric bypass surgery (RYGB), using a comprehensive nerve conduction study (NCS) protocol.</p></div><div><h3>Methods</h3><p>Patients (n = 175, mean age 52.0, BMI 35.2) and 86 community-controls (mean age 56.8, BMI 27.2) had NCS of one upper and lower limb. New abnormality scores from 27 polyneuropathy-relevant (PNP27s) and four carpal tunnel syndrome-relevant NCS-measures (CTS4s) were compared between groups with non-parametric statistics. Estimated prevalences were compared by 95 % confidence limits. The clinical neurophysiologist’s diagnosis was retrieved from hospital records (PNP-ncs, CTS-ncs, other).</p></div><div><h3>Results</h3><p>Abnormality score did not differ between RYGB and control groups (PNP27s: 1.9 vs 1.7, CTS4s: 0.7 vs 0.6, p > 0.29). BMI correlated weakly with CTS4s in patients (rho = 0.19, p = 0.01), and less with PNP27s (rho = 0.12, p = 0.12). Polyneuropathy (PNP-ncs) prevalence was 12 % in patients and 8 % in controls. CTS-ncs prevalence was 21 % in patients and 10 % in controls (p = 0.04).</p></div><div><h3>Conclusions</h3><p>NCS-based abnormality scores did not differ between patients 10–15 years after RYGB and community-recruited controls, neither for PNP nor CTS.</p></div><div><h3>Significance</h3><p>Long-term polyneuropathic complications from RYGB have probably been avoided by modern treatment guidelines. NCS-diagnosed CTS is common in overweight RYGB patients. 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Neuropathy 10–15 years after Roux-en-Y gastric bypass for severe obesity: A community-controlled nerve conduction study
Objective
We searched for long-term peripheral nerve complications 10–15 years after Roux-en-Y gastric bypass surgery (RYGB), using a comprehensive nerve conduction study (NCS) protocol.
Methods
Patients (n = 175, mean age 52.0, BMI 35.2) and 86 community-controls (mean age 56.8, BMI 27.2) had NCS of one upper and lower limb. New abnormality scores from 27 polyneuropathy-relevant (PNP27s) and four carpal tunnel syndrome-relevant NCS-measures (CTS4s) were compared between groups with non-parametric statistics. Estimated prevalences were compared by 95 % confidence limits. The clinical neurophysiologist’s diagnosis was retrieved from hospital records (PNP-ncs, CTS-ncs, other).
Results
Abnormality score did not differ between RYGB and control groups (PNP27s: 1.9 vs 1.7, CTS4s: 0.7 vs 0.6, p > 0.29). BMI correlated weakly with CTS4s in patients (rho = 0.19, p = 0.01), and less with PNP27s (rho = 0.12, p = 0.12). Polyneuropathy (PNP-ncs) prevalence was 12 % in patients and 8 % in controls. CTS-ncs prevalence was 21 % in patients and 10 % in controls (p = 0.04).
Conclusions
NCS-based abnormality scores did not differ between patients 10–15 years after RYGB and community-recruited controls, neither for PNP nor CTS.
Significance
Long-term polyneuropathic complications from RYGB have probably been avoided by modern treatment guidelines. NCS-diagnosed CTS is common in overweight RYGB patients. RYGB-patients with significant neuropathic symptoms need clinical evaluation.
期刊介绍:
Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.