中国普通外科杂志2025，Vol.34Issue(4)：698-707,10.DOI:10.7659/j.issn.1005-6947.240529
术前肝肾功能及血脂谱与减重代谢手术后进食紊乱症状改善的相关性研究
Association of preoperative hepatorenal function and lipid profile with improvement in disordered eating symptoms after bariatric metabolic surgery
摘要
Abstract
Background and Aims:Obesity is often accompanied by symptoms of disordered eating.Although bariatric metabolic surgery can alleviate these symptoms,there are significant individual differences in postoperative outcomes,and effective predictive indicators are lacking.Liver and kidney function,along with lipid profiles,are closely related to metabolic status and may serve as useful markers for preoperative risk stratification and prognosis prediction.This study was conducted to explore the relationship between preoperative metabolic indicators and symptoms of disordered eating,thereby identifying postoperative recovery patterns among obese patients to support individualized management strategies. Methods:A total of 41 obese patients who underwent sleeve gastrectomy at Shanghai Sixth People's Hospital between September 2020 and June 2023 were enrolled,along with 36 healthy volunteers recruited during the same period.Participants completed the Eating Disorder Inventory-2(EDI-2)questionnaire,and serum samples were collected to assess liver function,kidney function,and lipid levels prior to surgery.The Mantel test was used to analyze correlations between metabolic indicators and EDI-2 scores.Latent profile analysis(LPA)was conducted using the indicators significantly correlated with EDI-2 scores to identify subgroups within the obese cohort.Linear mixed models were then applied to examine the trajectories of postoperative symptom changes across subgroups. Results:Levels of cystatin C,cholinesterase,gamma-glutamyl transferase,triglycerides,and apolipoprotein E were significantly higher in the obese group compared to the healthy group(all P＜0.05),and EDI-2 total score was also significantly elevated(P＜0.05);the prealbumin level in the healthy group was significantly higher than that in the obese group(P＜0.05).These six indicators were positively correlated with EDI-2 score(all r＞0.20,P＜0.05).Based on these markers,the LPA classified the obese group into two subgroups,with subgroup 2 exhibiting higher levels of most metabolic indicators than subgroup 1.During the 18-month postoperative follow-up,both subgroups showed reductions in EDI-2 score,but symptom improvement in subgroup 2 occurred later(month 6)compared to subgroup 1(month 4). Conclusion:Preoperative levels of cholinesterase,gamma-glutamyl transferase,prealbumin,triglycerides,and apolipoprotein E may serve as predictive indicators for improvement in disordered eating symptoms.Recovery patterns after bariatric surgery vary among obese patients with different metabolic profiles,highlighting the need for tailored intervention strategies.关键词
减肥手术/肥胖/饮食与进食障碍/肝功能试验/肾功能试验/血脂异常Key words
Bariatric Surgery/Obesity/Feeding and Eating Disorders/Liver Function Tests/Kidney Function Tests/Dyslipid-emias分类
临床医学引用本文复制引用
张惠淋,许听,王晨,张弘玮,狄建忠..术前肝肾功能及血脂谱与减重代谢手术后进食紊乱症状改善的相关性研究[J].中国普通外科杂志,2025,34(4):698-707,10.基金项目
国家自然科学基金资助项目(82370901). （82370901）
