袖状胃切除术与胃旁路术在减重手术后一年改善抑郁症状的比较：德黑兰肥胖治疗研究（TOTS）。

Sleeve gastrectomy vs gastric bypass in improvement of depressive symptoms following one year from bariatric surgery, Tehran Obesity Treatment Study (TOTS).

机构信息

Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran.

出版信息

Obes Res Clin Pract. 2020 Jan-Feb;14(1):73-79. doi: 10.1016/j.orcp.2019.11.002. Epub 2020 Jan 8.

DOI:10.1016/j.orcp.2019.11.002

PMID:31924542

Abstract

BACKGROUND

The Beck Depression Inventory (BDI) has been frequently employed as a measure of depression in studies of obesity, with the majority of studies reporting an improvement in scores following weight loss after bariatric surgery. However, the effects of different bariatric techniques on depression score improvement is uncertain.

METHOD

The study included 685 obese patients who underwent laparoscopic sleeve gastrectomy (SG) (n = 443) or gastric bypass (GB) (n = 242) and completed BDIs at baseline and 1 year after surgery.

RESULTS

Mean age of the patients was 38.7 ± 10.9 (84.8% female), and mean body mass index (BMI) was 45.1 ± 6.0 kg/m. One year after surgery, excess weight loss (EWL %) in the GB group was more than the SG group (65.4% vs 62.8% P = 0.02). At baseline, 29.9% of patients had BDI scores in the normal range (0-9), and respectively 32.4 %, 28.3 % and 9.3 % had mild (10-18), moderate (19-29) and sever (+30) depression score; these corresponding values after 1 year were 60.6, 23.2, 11.8 and 4.4%. Overall, BDI scores fell in both surgery groups after 1 year, in the GB group it was 17.2 ± 10.5 vs 11.1 ± 9.6, and for the SG group 16.1 ± 10.2 vs 9.6 ± 8.9. However BDI score change (ΔBDI) was not significantly different between two surgery groups (-6.04 ± 10.6 vs -6.4 ± 9.5, P = 0.149).

CONCLUSION

Bariatric surgery had a beneficial effect on weight reduction and BDI score regardless of its type. Further studies with longer follow-up and more samples are needed to clarify the differences between bariatric procedures.

摘要

背景

贝克抑郁自评量表（BDI）常用于肥胖症研究中的抑郁评估，大多数研究报告称，减重手术后体重减轻会导致评分改善。然而，不同减重术式对抑郁评分改善的影响尚不确定。

方法

本研究纳入了 685 名接受腹腔镜袖状胃切除术（SG）（n=443）或胃旁路术（GB）（n=242）的肥胖患者，分别在基线和术后 1 年时完成了 BDI 评估。

结果

患者平均年龄为 38.7±10.9 岁（84.8%为女性），平均体重指数（BMI）为 45.1±6.0kg/m。术后 1 年时，GB 组的体重减轻百分比（EWL%）大于 SG 组（65.4% vs 62.8%，P=0.02）。基线时，29.9%的患者 BDI 评分处于正常范围（0-9），分别有 32.4%、28.3%和 9.3%的患者为轻度（10-18）、中度（19-29）和重度（≥30）抑郁；术后 1 年时，相应值分别为 60.6%、23.2%、11.8%和 4.4%。总体而言，两组手术患者在术后 1 年均有 BDI 评分下降，GB 组为 17.2±10.5 分降至 11.1±9.6 分，SG 组为 16.1±10.2 分降至 9.6±8.9 分。然而，两组手术之间 BDI 评分变化（ΔBDI）无显著差异（-6.04±10.6 分 vs -6.4±9.5 分，P=0.149）。