袖带胃切除术后 24 个月，通过计算机断层扫描观察重度肥胖症青少年胰腺脂肪变性的变化。

IF 3.5 3区医学 Q1 SURGERY

Surgery for Obesity and Related Diseases Pub Date : 2025-01-01 DOI:10.1016/j.soard.2024.08.034

Imen Becetti M.D. , Ana Paola Lopez Lopez M.D. , Francesca Galbiati M.D. , Clarissa C. Pedreira M.D. , Meghan Lauze B.S. , Karen Olivar Carreno M.D. , Florian A. Huber M.D. , Olivier Bitoun M.D. , Hang Lee Ph.D. , Brian Carmine M.D. , Vibha Singhal M.D., M.P.H. , Madhusmita Misra M.D., M.P.H. , Miriam A. Bredella M.D., M.B.A.

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引用次数: 0

摘要

背景：胰腺脂肪变性与肥胖和代谢综合征有关。成人研究表明，袖带胃切除术（SG）后胰腺脂肪变性有所改善，同时葡萄糖稳态也得到改善：目的：研究袖带胃切除术 24 个月后，重度肥胖青少年胰腺脂肪变性的变化：地点：学术医院系统：对 47 名患有严重肥胖症的青少年（13-24 岁）（37 名女性）进行了为期 24 个月的随访；其中 23 人接受了 SG 治疗，24 人为非手术（NS）对照组。在基线、12 个月和 24 个月的随访期间，使用计算机断层扫描（CT）测量了胰腺和脾脏的衰减情况。受试者接受了皮下和内脏脂肪组织（SAT、VAT）的磁共振成像（MRI）、身体成分的双能 X 射线吸收测量（DXA）、糖化血红蛋白（A1C）的血液采样以及空腹和餐后胰岛素和葡萄糖的检测。线性混合效应（LMEs）模型用于比较 24 个月中组内和组间的变化：基线时，SG 的体重指数（BMI）高于 NS（P = .033）。在 24 个月内，SG 组与 NS 组相比，体重、BMI、VAT、SAT、脂肪量（FM）和瘦肉量（LM）均有明显下降（P ≤ .0001）。24 个月后，SG 组的胰腺脂肪变性明显减少（P = .006）。在全组中，胰腺脂肪变性在 24 个月内的减少与 BMI 和 FM 的减少相关。胰腺脂肪变性与糖稳态参数之间没有关联：结论：青少年接受 SG 治疗后，通过 CT 测量的胰腺脂肪变性有所改善。需要进一步研究以了解胰腺脂肪变性与葡萄糖稳态之间的关系。

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Changes in pancreatic steatosis by computed tomography 24 months after sleeve gastrectomy in youth with severe obesity

Background

Pancreatic steatosis has been associated with obesity and the metabolic syndrome. Studies in adults have demonstrated improvement in pancreatic steatosis following sleeve gastrectomy (SG) with concomitant improvement in glucose homeostasis.

Objectives

To examine changes in pancreatic steatosis in youth with severe obesity 24 months following SG.

Setting

Academic hospital system.

Methods

Forty-seven youth (13–24 years) with severe obesity (37 females) were followed for 24 months; 23 had SG and 24 were nonsurgical (NS) controls. Attenuations of the pancreas and spleen were measured using computed tomography (CT) at baseline, 12- and 24-month follow-up. Subjects underwent magnetic resonance imaging (MRI) for subcutaneous and visceral adipose tissue (SAT, VAT), dual energy x-ray absorptiometry (DXA) for body composition, blood sampling for glycated hemoglobin (A1C), and fasting and postprandial insulin and glucose. Linear mixed effects (LMEs) models were used to compare within- and between-group changes over 24 months.

Results

At baseline, SG had higher body mass index (BMI) versus NS (P = .033). Over 24 months, significant reductions were noted in weight, BMI, VAT, SAT, fat mass (FM), and lean mass (LM) in the SG versus NS groups (P ≤ .0001). There was a significant 24-month decrease in pancreatic steatosis in the SG group (P = .006). In the whole group, 24-month reductions in pancreatic steatosis correlated with BMI and FM decreases. No associations were found between pancreatic steatosis and glucose homeostasis parameters.

Conclusions

Pancreatic steatosis measured by CT improved after SG in youth. Further studies are needed to understand the relationship between pancreatic steatosis and glucose homeostasis.

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来源期刊

Surgery for Obesity and Related Diseases 医学-外科

CiteScore

6.70

自引率

12.90%

发文量

570

审稿时长

56 days

期刊介绍： Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS) and the Brazilian Society for Bariatric Surgery, is an international journal devoted to the publication of peer-reviewed manuscripts of the highest quality with objective data regarding techniques for the treatment of severe obesity. Articles document the effects of surgically induced weight loss on obesity physiological, psychiatric and social co-morbidities.