内镜下套筒胃成形术降低动脉粥样硬化性心血管疾病风险：一项使用合并队列方程和预测心血管疾病事件模型的队列研究

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy Pub Date : 2025-01-01 DOI:10.1016/j.tige.2025.250942

Ali Lahooti , Chino Aneke-Nash , Kate E. Johnson , Anam Rizvi , Muhammad U. Baig , Alpana Shukla , Carolyn Newberry , Emily Smith , Jude M. Sharaiha , Mark Hanscom , Kartik Sampath , David L. Carr-Locke , SriHari Mahadev , Sonal Kumar , Robert Schwartz , Samuel M. Kim , Reem Z. Sharaiha

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引用次数: 0

摘要

背景：aimsenscopic sleeve gastroplasty （ESG）是一种治疗肥胖的微创手术，肥胖是动脉粥样硬化性心血管疾病（ASCVD）的危险因素。然而，其对心血管风险的影响仍未得到充分探讨。本研究评估ESG对ASCVD风险和肥胖相关合并症的影响。方法在这项队列研究中，168名肥胖成人（年龄30-79岁，体重指数≥30 kg/m2或≥27 kg/m2，有合并症）于2013年至2024年在一家三级医疗机构接受了ESG检查。在基线和手术后12个月，对40-79岁的患者使用合并队列方程（pce），对30-79岁的患者使用心血管疾病事件预测风险方程（prevention）进行评估。还分析了体重、血糖控制、血压、血脂（总胆固醇、低脂蛋白和高密度脂蛋白胆固醇、甘油三酯）和肝酶（丙氨酸转氨酶）的变化。结果168例患者（中位年龄48岁，女性占74%，体重指数36.0 kg/m2），分别有129例和159例符合pce和PREVENT方程的纳入标准。在12个月时，PCEs ASCVD风险评分中位数从3.3%下降到3.0%（降低21%，P < 0.001），而prevention 10年心血管疾病风险评分从3.1%下降到2.4%（降低20%，P < 0.001）， 30年风险评分也有类似的降低，高/中危患者和50岁患者的改善更大。患者的中位总体重减轻13.5% (IQR, 8.1%-18.6%)，代谢显著改善，80%的患者糖尿病得到缓解。有1例（0.6%）中度不良事件。结论：接受ESG的成年人在手术后12个月ASCVD风险和肥胖相关合并症有显著改善。这些发现表明，ESG可能是控制肥胖和减轻肥胖患者心血管风险的有效干预措施。ClincialTrials.gov识别码：NCT04494048。

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Endoscopic Sleeve Gastroplasty Reduces Atherosclerotic Cardiovascular Disease Risk: A Cohort Study Using Pooled Cohort Equations and Predicting Risk of Cardiovascular Disease Events Models

BACKGROUND AND AIMS

Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure for obesity, a risk factor for atherosclerotic cardiovascular disease (ASCVD). However, its impact on cardiovascular risk remains underexplored. This study evaluates ESG’s effects on ASCVD risk and obesity-related comorbidities.

METHODS

In this cohort study, 168 adults with obesity (aged 30-79 years; body mass index, ≥30 kg/m² or ≥27 kg/m²; with comorbidities) underwent ESG at a single tertiary care facility from 2013 to 2024. Patients were evaluated at baseline and 12 months after procedure using the Pooled Cohort Equations (PCEs) for patients aged 40-79 years and the Predicting Risk of Cardiovascular Disease Events (PREVENT) equations for those aged 30-79 years. Changes in body weight, glycemic control, blood pressure, lipid profile (total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides), and liver enzymes (alanine aminotransferase) were also analyzed.

RESULTS

Of the 168 patients (median age, 48 years; 74% female; body mass index, 36.0 kg/m²), 129 and 159 met inclusion criteria for PCEs and PREVENT equations, respectively. At 12 months, median PCEs ASCVD risk score decreased from 3.3% to 3.0% (21% reduction, P < 0.001), while the PREVENT 10-year cardiovascular disease risk score declined from 3.1% to 2.4% (20% reduction; P < 0.001), with similar reductions in 30-year risk scores and greater improvements in high/intermediate-risk patients and those aged >50 years. Patients achieved a median total body weight loss of 13.5% (IQR, 8.1%-18.6%), with significant metabolic improvements, and >80% experienced diabetes resolution. There was 1 (0.6%) moderate adverse event.

CONCLUSION

Adults who underwent ESG showed significant improvements in ASCVD risk and obesity-related comorbidities at 12 months after procedure. These findings suggest that ESG may be an effective intervention for managing obesity and mitigating cardiovascular risk in patients with obesity. ClincialTrials.gov identifier: NCT04494048.

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来源期刊

Techniques and Innovations in Gastrointestinal Endoscopy Medicine-Gastroenterology

CiteScore

2.10

自引率

50.00%

发文量