Comparative study on curative effect of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the treatment of obesity-associated hypertension

doi:10.3877/cma.j.issn.2095-9605.2019.01.004

Abstract

Abstract:

Objective

To compare the efficacy of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric Bypass in the treatment of obesity-associated hypertension.

Methods

The clinical data of 46 patients with obesity-associated hypertension who were admitted to the China-Japan Union hospital of JiLin university from November 2015 to June 2017 were retrospectively analyzed. They were divided into LSG group and LRYG group according to the different surgical methods. Among the 32 cases of LSG group, 9 cases were male and 23 cases were female with an average age of (40.09±12.22) years old. Among the 14 patients of LRYGB group, 9 cases were male and 5 cases were female with an average age of (40.09±12.22) years old. Blood pressure, heart rate, body weight, body mass index, waist circumference, fasting blood glucose, glycosylated hemoglobinAlc,fasting blood insulin, fasting plasma C-peptide, triglyceride, total cholesterol and uric acid levels were compared between two groups.

Results

All patients were treated successfully by bariatric surgery and followed up after operation. At postoperative 3 months, both LSG group and LRYGB group, their systolic blood pressure, diastolic blood pressure, heart rate, body weight,BMI, waist circumference, fasting blood glucose, glycosylated hemoglobin Alc, fasting blood insulin, fasting C-peptide, triglyceride, cholesterol and uric acid levels were decreased significantly except for cholesterol. The operation time and heart rate were statistically significant between LSG group and LGBP group, but there was no significant difference in other indexes.

Conclusions

LSG and LRYGB can both significantly improve blood pressure and other metabolic diseases except for cholesterol in a short time, but there is no significant difference between the two groups except for heart rate, the difference between their curative effect remains to be defined by extending follow-up time and increasing sample sizes.

Key words: Obesity, Hypertension, Laparoscopic Roux-en-Y gastric bypass, Laparoscopic sleeve gastrectomy

Lun Wang, Shixing Li, Jinfa Wang, Yang Yu, Tao Jiang. Comparative study on curative effect of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the treatment of obesity-associated hypertension[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2019, 05(01): 20-25.

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References 30

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组别	例数	性别		年龄（岁）	收缩压（mmHg）	舒张压（mmHg）	心率（次/min）	体重（kg）	BMI（kg/m²）	腰围（cm）
组别	例数	男	女	年龄（岁）	收缩压（mmHg）	舒张压（mmHg）	心率（次/min）	体重（kg）	BMI（kg/m²）	腰围（cm）
LSG组	32	9	23	40.09±12.22	152.06±17.53	93.63±14.31	81.29±12.46	97.08±17.50	34.82±4.74	113.19±12.06
LRYGB组	14	9	5	42.07±13.51	150.29±16.82	90.07±8.28	80.29±8.48	128.36±41.54	42.53±10.94	131.54±24.10
统计值	?	χ²=5.347		t=-0.489	t=0.320	U=193.50	t=0.315	t=-2.704	t=-2.525	t=-2.699
P值	?	0.021		0.627	0.750	0.466	0.754	0.016	0.023	0.016
组别	例数	FPG（mmol/L）	HbAlc（%）	FINS（mu/L）	FCP（nmol/L）	TG（mmol/L）	CHOL（mmol/L）	尿酸（umol/L）
LSG组	32	10.28±3.12	8.79±1.90	42.01±43.73	2.49±1.25	2.93±1.33	6.56±0.68	449.34±60.35
LRYGB组	14	12.17±4.03	8.81±1.90	40.06±40.83	3.87±1.40	5.59±5.44	9.11±1.00	530.35±136.37
统计值	?	t=-1.378	U=84.50	U=85.00	t=-2.617	U=81.50	U=0.000	t=-1.515
P值	?	0.180	0.795	0.980	0.015	0.322	0.04	0.174

组别	例数	性别		年龄（岁）	收缩压（mmHg）	舒张压（mmHg）	心率（次/min）	体重（kg）	BMI（kg/m²）	腰围（cm）
组别	例数	男	女	年龄（岁）	收缩压（mmHg）	舒张压（mmHg）	心率（次/min）	体重（kg）	BMI（kg/m²）	腰围（cm）
LSG组	32	9	23	40.09±12.22	152.06±17.53	93.63±14.31	81.29±12.46	97.08±17.50	34.82±4.74	113.19±12.06
LRYGB组	14	9	5	42.07±13.51	150.29±16.82	90.07±8.28	80.29±8.48	128.36±41.54	42.53±10.94	131.54±24.10
统计值	?	χ²=5.347		t=-0.489	t=0.320	U=193.50	t=0.315	t=-2.704	t=-2.525	t=-2.699
P值	?	0.021		0.627	0.750	0.466	0.754	0.016	0.023	0.016
组别	例数	FPG（mmol/L）	HbAlc（%）	FINS（mu/L）	FCP（nmol/L）	TG（mmol/L）	CHOL（mmol/L）	尿酸（umol/L）
LSG组	32	10.28±3.12	8.79±1.90	42.01±43.73	2.49±1.25	2.93±1.33	6.56±0.68	449.34±60.35
LRYGB组	14	12.17±4.03	8.81±1.90	40.06±40.83	3.87±1.40	5.59±5.44	9.11±1.00	530.35±136.37
统计值	?	t=-1.378	U=84.50	U=85.00	t=-2.617	U=81.50	U=0.000	t=-1.515
P值	?	0.180	0.795	0.980	0.015	0.322	0.04	0.174

?	收缩压（mmHg）	舒张压（mmHg）	心率（次/min）	体重（kg）	BMI（kg/m²）	腰围（cm）
术前	152.06±17.53	93.63±14.31	81.73±12.42	97.08±17.50	34.82±4.74	113.63±12.31
术后	129.97±16.40	80.06±11.31	75.20±7.40	79.55±14.64	24.48±4.19	96.59±12.10
统计值	t=7.903	U=166.50	t=3.094	t=17.387	t=17.955	t=13.482
P值	0.000	0.000	0.004	0.000	0.000	0.000
?	FPG（mmol/L）	HBALc（%）	FINS（mu/L）	FCP（nmol/L）	TG（mmol/L）	CHOL（mmol/L）	尿酸（umol/L）
术前	10.49±3.06	8.79±1.90	39.18±43.18	2.49±1.25	2.93±1.33	6.56±0.68	449.34±60.35
术后	7.31±2.02	6.95±1.39	13.19±8.81	1.82±0.79	1.93±1.17	5.06±0.99	386.98±80.65
统计值	t=4.438	U=78.00	U=64.00	t=3.450	U=61.00	t=1.572	t=3.393
P值	0.000	0.001	0.002	0.003	0.000	0.167	0.003

?	收缩压（mmHg）	舒张压（mmHg）	心率（次/min）	体重（kg）	BMI（kg/m²）	腰围（cm）
术前	152.06±17.53	93.63±14.31	81.73±12.42	97.08±17.50	34.82±4.74	113.63±12.31
术后	129.97±16.40	80.06±11.31	75.20±7.40	79.55±14.64	24.48±4.19	96.59±12.10
统计值	t=7.903	U=166.50	t=3.094	t=17.387	t=17.955	t=13.482
P值	0.000	0.000	0.004	0.000	0.000	0.000
?	FPG（mmol/L）	HBALc（%）	FINS（mu/L）	FCP（nmol/L）	TG（mmol/L）	CHOL（mmol/L）	尿酸（umol/L）
术前	10.49±3.06	8.79±1.90	39.18±43.18	2.49±1.25	2.93±1.33	6.56±0.68	449.34±60.35
术后	7.31±2.02	6.95±1.39	13.19±8.81	1.82±0.79	1.93±1.17	5.06±0.99	386.98±80.65
统计值	t=4.438	U=78.00	U=64.00	t=3.450	U=61.00	t=1.572	t=3.393
P值	0.000	0.001	0.002	0.003	0.000	0.167	0.003

?	收缩压（mmHg）	舒张压（mmHg）	心率（次/min）	体重（kg）	BMI（kg/m²）	腰围（cm）
术前	150.29±16.82	90.07±8.28	95.14±13.31	128.36±41.54	42.53±10.94	131.54±24.10
术后	130.71±12.19	82.21±10.32	80.29±8.48	105.50±33.45	34.89±8.67	115.36±22.85
统计值	t=9.235	t=2.786	t=4.539	t=7.926	t=8.988	t=8.817
P值	0.000	0.015	0.001	0.000	0.000	0.000
?	FPG（mmol/L）	HBALc（%）	FINS（mu/L）	FCP（nmol/L）	TG（mmol/L）	CHOL（mmol/L）	尿酸（umol/L）
术前	12.17±4.03	8.81±1.99	40.06±40.83	3.87±1.40	5.59±5.44	9.11±1.00	530.35±136.37
术后	6.40±1.33	6.32±0.92	15.03±9.91	2.32±0.92	1.68±0.83	4.48±0.25	424.32±74.44
统计值	t=4.068	t=4.047	t=2.301	t=2.978	U=18.00	U=0.000	U=9.00
P值	0.004	0.004	0.05	0.018	0.005	0.121	0.048

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