抑郁症对肥胖症患者减重代谢手术效果的影响

Influence of depression on bariatric/metabolic surgery in obese patients

目的 观察肥胖症伴抑郁症患者行减重代谢手术后体质量及体质量指数(body mass index, BMI)变化,探讨抑郁症对减重代谢手术效果的影响。方法 247例肥胖症患者(BMI≥28 kg/m^(2)),其中86例合并抑郁症者为抑郁症组,161例无抑郁症者为无抑郁症组。2组减重代谢手术采用腹腔镜袖状胃切除术或腹腔镜袖状胃切除术+空肠旁路术。比较2组性别、年龄、合并症、手术方式及术前体质量、BMI;计算术后3、6、12、24、36个月体质量减少值和BMI减少值,并进行比较。结果 (1)抑郁症组年龄[(32.1±8.8)岁]小于无抑郁症组[(34.7±8.7)岁](t=-2.237,P=0.026),男性及合并高血压、糖尿病、高脂血症、高尿酸血症、多囊卵巢综合征、脂肪肝、脂肪胰比率、行胃袖状切除术比率与无抑郁症组比较差异均无统计学意义(P>0.05)。(2)抑郁症组术前BMI[41.2(37.8,44.3)kg/m^(2)]大于无抑郁症组[37.3(34.0,40.5)kg/m^(2)](U=-5.444,P=0.024),术前体质量与无抑郁症组比较差异无统计学意义(P<0.05)。抑郁症组术后3个月体质量减少值[19.9(14.3,25.0) kg]、BMI减少值[6.9(5.1,8.9) kg/m^(2)]均低于无抑郁症组[21.8(16.1,28.3)kg、7.8(5.6,10.2)kg/m^(2)](U=-1.969,P=0.049;U=-2.466,P=0.014),术后6、12、24、36个月体质量减少值和BMI减少值与无抑郁症组比较差异均无统计学意义(P>0.05)。结论 年轻、BMI大的肥胖症患者抑郁症发生率高,抑郁症可影响减重代谢手术的短期效果。

Objective To observe the changes of body mass and body mass index(BMI)in obese depressed patients after bariatric/metabolic surgery,and to investigate the influence of depression on the surgical outcome.Methods In 247 obese patients(BMI≥28 kg/m^(2)),there were 86 patients with depression(depression group),and 161 patients without depression(non-depression group).The gender,age,complications,surgical methods,preoperative body mass and preoperative BMI were compared between two groups after laparoscopic sleeve gastrectomy or laparoscopic sleeve gastrectomy+jejunal bypass.The decreased values of body mass and BMI 3,6,12,24 and 36 months after surgery were recorded and compared between two groups.Results(1)The patients were younger in depression group[(32.1±8.8)years]than non-depression group[(34.7±8.7)years](t=-2.237,P=0.026),and there were no significant differences in the male ratio and the percentages of patients with hypertension,diabetes,hyperlipidemia,hyperuricemia,polycystic ovary syndrome,fatty liver,fatty pancreas,and laparoscopic sleeve gastrectomy between two groups(P>0.05).(2)The preoperative BMI was higher in depression group[41.2(37.8,44.3)kg/m^(2)]than that in non-depression group[37.3(34.0,40.5)kg/m^(2)](U=-5.444,P=0.024),and the preaperative body mass showed no significant difference between two groups(P>0.05).The decreased values of body mass and BMI were lower in depression group[19.9(14.3,25.0)kg,6.9(5.1,8.9)kg/m^(2)]than those in non-depression group[21.8(16.1,28.3)kg,7.8(5.6,10.2)kg/m^(2)]3 months after surgery(U=-1.969,P=0.049;U=-2.466,P=0.014),and showed no significant differences 6,12,24 and 36 months after surgery between two groups(P>0.05).Conclusion Young obese patients with high BMI have a high incidence of depression,and depression can affect the short-term results of bariatric/metabolic surgery.