体重指数与减重代谢手术的关系

发布时间：2018-06-19 14:24

  本文选题：体重指数 + 减重手术　； 参考：《南京医科大学学报(自然科学版)》2016年01期

【摘要】：减重代谢手术成为临床上最重要的创新之一,在2013年被Cleveland Clinic评选为当年医学十大创新之首。代谢手术治疗肥胖型糖尿病的临床效果远远优于单纯的内科药物治疗,传统的饮食控制和运动、生活方式改变等已被证明对于重度肥胖患者几乎是无效的,代谢手术成为减重和治疗代谢并发症的有效手段。在中国由于2型糖尿病占糖尿病的95%左右,而且控糖达标率较低,手术减重降糖已经成为临床的热点。随着减重代谢手术指南在中国的大力推广,越来越多的问题也逐渐暴露出来;在临床上也有许多医生对于各种指南和共识中体重指数(body mass index,BMI)的限制表示不解。那么BMI和减重代谢手术到底是一种什么样的关系?BMI是目前应用最广泛的判断肥胖的指标,但是它并不能真实反映腹腔内脂肪的含量,因此在以BMI为基础的各种减重代谢外科指南中不同地区及国家分别给出了不同的标准,在亚洲增加了腰围的标准。在手术适应证方面亚洲国家给出的BMI标准比西方低,而代谢手术的适应证不同于减重手术,从糖尿病并发症的预防来说,美国临床内分泌医师协会和美国内分泌学会也发布了新的共识。
[Abstract]:Weight-loss metabolic surgery has become one of the most important innovations in clinical practice and was named the top ten innovations in medicine by the Cleveland Clinic in 2013. The clinical effect of metabolic surgery in the treatment of obese type diabetes is much better than that of medical medicine alone. Traditional diet control and exercise, lifestyle changes have been proved to be almost ineffective for severely obese patients. Metabolic surgery has become an effective means of weight loss and metabolic complications. In China, type 2 diabetes mellitus accounts for about 95% of diabetes mellitus, and the rate of glucose control is low. With the expansion of guidelines for weight-loss and metabolic surgery in China, more and more problems have emerged, and many doctors in the clinic have expressed confusion about the limitations of the guidelines and consensus on body mass index (BMI). So what is the relationship between BMI and metabolic surgery? BMI is the most widely used indicator of obesity, but it doesn't really reflect the amount of fat in the abdominal cavity. Therefore, different regions and countries give different standards in various BMI-based guidelines for weight-loss surgery, and increase waistline standards in Asia. In terms of surgical indications, Asian countries have given lower BMI standards than those in the West, while metabolic surgery is different from weight-loss surgery in terms of the prevention of diabetic complications. The American Association of Clinical Endocrinologists and the American Endocrine Society have also released a new consensus.
【作者单位】： 南京医科大学第一附属医院普外科;
【分类号】：R656.6;R589.2
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本文编号：2040184