中国普通外科杂志2025，Vol.34Issue(4)：676-685,10.DOI:10.7659/j.issn.1005-6947.240441
司美格鲁肽治疗减重术后减重不足或体质量反弹患者有效性与安全性的Meta分析
Efficacy and safety of semaglutide in patients with insufficient weight loss or weight regain following bariatric surgery:a Meta-analysis
摘要
Abstract
Background and Aims:Approximately 20％-25％of individuals experience insufficient weight loss(IWL)or weight regain(WR)after bariatric surgery.However,there is limited research on using semaglutide in this patient population,and its efficacy and safety remain to be confirmed.Therefore,this study was conducted to evaluate the effectiveness and safety of semaglutide in patients with IWL or WR after bariatric surgery through a systematic review to provide evidence to support clinical decision-making. Methods:A comprehensive search was conducted across multiple domestic and international databases for studies using semaglutide in patients with IWL or WR after bariatric surgery.The search period was from the database's inception to July 1,2024.Relevant studies were screened according to inclusion and exclusion criteria,and data were analyzed using Stata 14.0 software. Results:A total of 5 retrospective studies were included,encompassing 289 patients who received semaglutide treatment after bariatric surgery.The analysis showed that,compared to baseline,semaglutide use resulted in an average total weight reduction of 10.66％(MD=10.66％,95％CI=6.47％-14.89％);body mass index decreased by 3.57 kg/m2(MD=3.57 kg/m2,95％CI=2.46-4.67 kg/m2);the type of surgery did not significantly affect the degree of weight loss(P＞0.05).The proportion of patients who experienced＞5％weight loss was 80％(OR=0.80,95％CI=0.76-0.85);＞10％weight loss was observed in 45％of patients(OR=0.45,95％CI=0.41-0.50);and＞15％weight loss occurred in 18％of patients(OR=0.18,95％CI=0.08-0.27).Most patients had undergone sleeve gastrectomy(69.8％).There was no significant difference in HbA1c levels before and after treatment(P＞0.05).The incidence of adverse events was 14％(OR=0.14,95％CI=0.01-0.28),primarily gastrointestinal side effects. Conclusion:Semaglutide can significantly reduce body weight in patients with IWL or WR after bariatric surgery,with a relatively low incidence of adverse effects.It may be considered for patients who experience suboptimal weight loss following bariatric surgery.However,further prospective and large-scale clinical studies are needed to confirm these findings.关键词
减肥手术/减重不足/体质量反弹/司美格鲁肽/Meta分析Key words
Bariatric Surgery/Insufficient Weight Reduction/Weight Regain/Semaglutide/Meta-Analysis分类
医药卫生引用本文复制引用
边识博,张翊乔,张萌,刘洋..司美格鲁肽治疗减重术后减重不足或体质量反弹患者有效性与安全性的Meta分析[J].中国普通外科杂志,2025,34(4):676-685,10.基金项目
北京市科学技术委员会首都临床诊疗技术研究及转化应用基金资助项目(Z211100002921029) （Z211100002921029）
国家重点研发计划基金资助项目(2022YFC2505204). （2022YFC2505204）
