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。
Bariatric and metabolic surgery has become one of the most important clinical innovations, in 2013 it was selected as top one innovation in medicine by the Cleveland Clinic. The clinical effect of metabolic surgery on the treatment of diabetes is far superior to the medical treatment, traditional diet control methods includes exercise, changing lifestyle and so on, which are almost invalid for severely obese patients, metabolic surgery has become an effective mean of weight loss and metabolic syndrome. In China about 95% of diabetes due to type 2 diabetes, and the ideal control rate is low, metabolic surgery to treat diabetes has become a clinical hot spot. With the bariatric and metabolic surgery guideline promoted in China, more and more problems are exposed gradually; many doctors were confused by the body mass index（BMI） constraints for various guidelines and consensus. So what is the relationship between BMI and bariatric and metabolic surgery？ BMI is the most widely measurement index of obesity, but it cannot reflect of the intra fat content totally, so a variety of bariatric and metabolic surgery guidelines were created using BMI as foundation in different regions and countries, in Asia waist circumference was added as an indicator. In metabolic surgery guideline,Asian countries give the lower BMI standard than that in the West, and metabolic surgery indication is different from bariatricsurgery, so from the prevention of diabetes complications, American association of clinical endocrinologists and American College of Endocrinology released a new consensus.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2016年第1期3-7,共5页
Journal of Nanjing Medical University(Natural Sciences)
关键词
体重指数
减重手术
代谢手术
手术适应证
body mass index
bariatric surgery
metabolic surgery
operation indication
