期刊
OBESITY SURGERY
卷 23, 期 10, 页码 1650-1654出版社
SPRINGER
DOI: 10.1007/s11695-013-0984-1
关键词
Estrogen; Menopause; Gastric bypass; Gastric banding; RYGB
类别
资金
- NCRR NIH HHS [KL2 RR024157] Funding Source: Medline
- NIDDK NIH HHS [P30 DK026687, R01 DK092608] Funding Source: Medline
Whether and how sex and age affect bariatric-surgery outcome is poorly understood. Estrogens regulate body composition in women and animals, and increase weight loss in a rodent model of gastric bypass, suggesting that premenopausal women may lose more weight following bariatric surgery. One thousand three hundred fifty-six female gastric-bypass or gastric-banding patients were retrospectively grouped as 20-45 years old (presumptively premenopausal; n = 1,199) and 55-65 years old (presumptively postmenopausal; n = 157). Mixed-model ANCOVA followed by Bonferroni-corrected t tests were used to categorically test the effect of age on percent excess body weight loss (%EBWL) at 1 and 2 years post-surgery, controlling for preoperative EBW and surgery type. Age effects were also tested dimensionally in all women and in 289 male patients. Twenty- to forty-five-year-old women showed greater %EBWL 1 and 2 years post-surgery than 55-65-year-old women (p's < 0.0005). No age effect was detected in 20-25- vs. 30-35-, 30-35- vs. 40-45-, or 20-25- vs. 40-45-year-old women (p's > 0.2) This age effect was detected only after gastric banding, with 20-45-year-old women losing similar to 7 kg more than 55-65-year-old women after 2 years. Dimensional analysis confirmed a significant inverse effect of age on bariatric surgery outcome in women, but did not detect any effect in men. Results indicate that 55-65-year-old women lose less weight than 20-45-year-old women in the initial 2 years after bariatric surgery, especially gastric banding; this may be mediated by age- or menopause-associated changes in physical activity, energy expenditure, or energy intake.
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