减肥手术与心脏结构和功能:系统回顾和网络荟萃分析。

IF 8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Obesity Reviews Pub Date : 2024-10-08 DOI:10.1111/obr.13843
Xiao-Qian Zhang, Ke-Ning Chen, Zu-Xuan Zhang, Nian-Rong Zhang, Fang-Jie-Yi Zheng, Biao Zhou, Hua Meng, Zhi-Xin Zhang, Wen-Quan Niu
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引用次数: 0

摘要

背景:肥胖症是一个全球性的健康问题,与心血管疾病的发生有着因果关系。减肥手术是治疗肥胖症的有效方法;然而,不同减肥手术对心脏结构和功能的效果尚不完全清楚。我们进行了一项系统综述和网络荟萃分析,以全面评估这种有效性:我们对 PubMed、Web of Science 和 EMBASE 进行了检索,检索时间从开始到 2023 年 11 月 11 日。对减肥手术与非手术治疗、安慰剂和其他减肥手术进行比较的研究,以及报告左心室质量或其指数(LVM 或 LVMI)或左心室射血分数(LVEF)变化的研究进行了汇总:共对 19 项研究(17 项队列研究和 2 项随机对照试验)和 2012 名成人进行了荟萃分析。接受胃旁路手术的患者LVM明显降低(加权平均差[WMD]:-43.86 g,95%置信区间[CI]-61.09至-26.63,P 2,95%CI-21.60至-11.05,P 结论:我们的这项网络荟萃分析结果表明,接受胃旁路手术的患者LVM明显降低:我们的网络荟萃分析结果表明,胃旁路手术对心脏结构的改善效果最好,而所有减肥手术对心脏功能的改善效果都不明显。要更好地了解减肥手术对心脏结构和功能的不同效果及其潜在的分子机制,还需要进一步的研究。
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Bariatric surgeries and cardiac structure and function: Systematic review and network meta-analysis.

Background: Obesity, a global health problem, is causally implicated in the development of cardiovascular disease. Bariatric surgeries are effective treatment options for obesity; however, the effectiveness of different bariatric surgeries on cardiac structure and function is not fully understood. We undertook a systematic review and network meta-analysis to comprehensively assess this effectiveness.

Data source: PubMed, Web of Science, and EMBASE were searched from their inception until November 11, 2023. Studies that compared bariatric surgeries vis-à-vis non-surgical treatment, placebo, and other bariatric surgeries, as well as reported changes in left ventricular mass or its index (LVM or LVMI) or left ventricular ejection fraction (LVEF), were summarized.

Results: Total 19 studies (17 cohort studies and 2 randomized controlled trials) and 2012 adults were meta-analyzed. Patients receiving gastric bypass had appreciably lowered LVM (weighted mean difference [WMD]: -43.86 g, 95% confidence interval [CI] -61.09 to -26.63, p < 0.01) and LVMI (standardized mean difference: -0.67, 95% CI -1.03 to -0.32, p < 0.01) compared with other bariatric surgeries. No significant improvement in LVEF was noted across all surgeries. The drop in body mass index was most pronounced for biliopancreatic diversion with duodenal switch (WMD -16.33 kg/m2, 95% CI -21.60 to -11.05, p < 0.01).

Conclusions: Our findings of this network meta-analysis indicated that gastric bypass proved best for the improvement in cardiac structure, and there was no obvious improvement in cardiac function for all bariatric surgeries. Further studies are required to better understand the differing effectiveness of bariatric surgeries on cardiac structure and function and the underlying molecular mechanisms.

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来源期刊
Obesity Reviews
Obesity Reviews 医学-内分泌学与代谢
CiteScore
19.30
自引率
1.10%
发文量
130
审稿时长
1 months
期刊介绍: Obesity Reviews is a monthly journal publishing reviews on all disciplines related to obesity and its comorbidities. This includes basic and behavioral sciences, clinical treatment and outcomes, epidemiology, prevention and public health. The journal should, therefore, appeal to all professionals with an interest in obesity and its comorbidities. Review types may include systematic narrative reviews, quantitative meta-analyses and narrative reviews but all must offer new insights, critical or novel perspectives that will enhance the state of knowledge in the field. The editorial policy is to publish high quality peer-reviewed manuscripts that provide needed new insight into all aspects of obesity and its related comorbidities while minimizing the period between submission and publication.
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