减重手术对肥胖合并焦虑症患者细胞因子水平的影响

Effect of weight loss surgery on cytokine levels in obese patients with anxiety disorder

目的探究减重手术对肥胖合并焦虑症患者细胞因子的影响。方法纳入2023年2-11月新疆维吾尔自治区胃食管反流病与减肥代谢外科临床研究中心微创外科收治的83例肥胖症患者的临床资料,在减重术前、术后3个月均完成Zung氏焦虑自评量表,判别患者是否存在焦虑状态,其中肥胖症合并焦虑症组(复杂组)40例,单纯肥胖症组(单纯组)43例。结果复杂组患者的血清白细胞介素-1β(IL-1β)[5.69(0.64,20.38)]、IL-2[2.93(0.04,16.85)]、IL-4[6.63(0.25,26.06)]、IL-6[71.10(52.05,149.00)]、IL-8[461.95(220.00,5072.00)]、IL-10[4.65(0.61,22.98)]、IL-12p70[3.18(0.01,15.31)]、IL-17[23.55(0.27,83.40)]、肿瘤坏死因子-α(TNF-α)[1.80(0.24,13.85)]、干扰素-γ(IFN-γ)[8.83(0.05,45.06)]比单纯组的血清IL-1β[1.97(0.32,8.89)]、IL-2[0.52(0.05,7.86)]、IL-4[0.52(0.05,11.44)]、IL-6[2.17(0.21,34.78)]、IL-8[27.12(0.79,281.00)]、IL-10[1.39(0.21,5.01)]、IL-12p70[0.06(0.01,6.13)]、IL-17[0.65(0.21,32.30)]、TNF-α[0.62(0.09,12.94)]、IFN-γ[1.95(0.01,18.61)]均升高,差异均有统计学意义(Z=-4.844、-4.835、-6.188、-7.838、-7.801、-6.074、-5.050、-5.050、-3.595、-5.397,均P<0.001);复杂组患者多因素Logistic回归分析显示:血清IL-1β(OR=2.992,95%CI:.527~6.175,P<0.001)、IL-6(OR=3.852,95%CI:0.012~9.814,P<0.001)、IL-8(OR=3.526,95%CI:0.976~5.407,P=0.003)、IL-10(OR=2.443,95%CI:0.003~7.789,P=0.022)是焦虑症的独立风险因素;复杂组患者在减重术后3个月血清IL-1β、IL-4、IL-6、IL-8、IL-17、TNF-α、IFN-γ均下降,差异均有统计学意义(Z=-2.251、-2.581、-5.511、-5.511、-3.710、-5.067、-2.984,均P<0.05)。结论减重手术不但可有效减轻体重和缓解肥胖患者的焦虑状态,而且可以降低肥胖伴焦虑患者细胞因子的表达水平。

Objective To explore the effect of weight loss surgery on cytokines in obese patients with anxiety disorder.Methods Clinical data of 83 obese patients admitted to the Minimally Invasive Surgery Department of the Gastroesophageal Reflux Disease and Weight Loss Metabolic Surgery,Clinical Research Center of Xinjiang Uygur Autonomous Region from Feb to Nov 2023 were included.Zung's Self Rating Anxiety Scale(SAS)was completed before and 3 months after weight loss surgery to assess the presence of anxiety in patients.Among them,there were 40 patients in the obesity combined with anxiety group(complex group)and 43 patients in the simple obesity group(simple group).Results In complex group,interleukin-1β(IL-1β)was[5.69(0.64,20.38)],IL-2[2.93(0.04,16.85)],IL-4[6.63(0.25,26.06)],IL-6[71.10(52.05,149.00)],IL-8[461.95(220.00,5072.00)],IL-10[4.65(0.61,22.98)],IL-12p70[3.18(0.01,15.31)],IL-17[23.55(0.27,83.40)],tumor necrosis factor-α(TNF-α)was[1.80(0.24,13.85)],interferon-γ(IFN-γ)[8.83(0.05,45.06)]compared to those in the simple group IL-1β[1.97(0.32,8.89)],IL-2[0.52(0.05,7.86)],IL-4[0.52(0.05,11.44)],IL-6[2.17(0.21,34.78)],IL-8[27.12(0.79,281.00)],IL-10[1.39(0.21,5.01)],IL-12p70[0.06(0.01,6.13)],IL-17[0.65(0.21,32.30)],TNF-α[0.62(0.09,12.94)],IFN-γ[1.95(0.01,18.61)](Z=-4.844,-4.835,-6.188,-7.838,-7.801,-6.074,-5.050,-5.050,-3.595,-5.397),all P<0.001;Multivariate logistic regression analysis showed:IL-1β(OR=2.992,95%CI:0.527-6.175,P<0.001),IL-6(OR=3.852,95%CI:0.012-9.814,P<0.001),IL-8(OR=3.526,95%CI:0.976-5.407,P=0.003),IL-10(0R=2.443,95%CI:0.003-7.789,P=0.022)are indipedent risk factors for complex group patients.Patients in complex group 3 months after surgery saw a significant decrease in IL-1β、IL-4、IL-6、IL-8、IL-17、TNF-α、IFN-γ(Z=-2.251,-2.581,-5.511,-5.511,-3.710,-5.067,-2.984),all P<0.05.Conclusion Weight loss surgery not only effectively reduces weight and alleviates anxiety in obese patients,but also reduces the expression of cytokines.