袖状胃切除术后病人体质量指数变化轨迹及其预测因素分析

The exploration of weight change trajectories and predictive factors after sleeve gastrectomy among severe obesity patients

目的探讨袖状胃切除术后病人1年体质量指数(BMI)变化的类别,识别其发展轨迹,并探索不良BMI轨迹的预测因素。方法2017年6月~2020年6月我院接受袖状胃切除手术治疗的肥胖病人241例,利用基线以及术后1、3、6、12个月的BMI数据构建增长混合模型。按照潜在类别分组对其基线资料进行组间比较。结果共得到3种不同类型的BMI变化轨迹,分别命名为常规减重(29.5%)、快速减重(27.0%)和缓慢减重(43.6%)。组间年龄、性别、婚姻状况比较差异有统计学意义。配对比较发现,性别和婚姻状况在组间的差异具有高效应。结论43.6%病人在袖状胃切除术后BMI下降趋势缓慢,女性和已婚是病人术后1年BMI下降趋势不理想的重要预测因素,病人年龄较轻也可辅助预测其术后减重效果。

Objective To explore one-year change trajectory in body mass index after sleeve gastrectomy among severe obesity patients,and then identify predictive factors of different trajectories.Methods 241 patients with sleeve gastrectomy were included.The data of body mass index at baseline,1,3,6,12 months after sleeve gastrectomy were used to construct the growth mixed model.And the baseline data were compared according to various trajectories.Results Three different trajectories were finally obtained,named as“Routine weight loss trajectory”(29.5%),“Rapid weight loss trajectory”(27.0%)and“Slow weight loss trajectory”(43.6%),respectively.There were significant differences in age,gender and marital status between different trajectories.Further paired compariso n showed that gender and marital status had significant effect on the difference between trajectories.Conclusion BMI decreased slowly in 43.6%patients after sleeve gastrectomy.Female and married status were important predictors of the unsatisfactory one-year weight loss trajectory after sleeve gastrectomy.Younger age also helps predict postoperative weight loss.