BACKGROUND Few long-term or controlled studies of bariatric surgery have been conducted to date. We report the 12-year follow-up results of an observational, prospective study of Roux-en-Y gastric bypass that was conducted in the United States. METHODS A total of 1156 patients with severe obesity comprised three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass (surgery group), 417 patients who sought but did not undergo surgery (primarily for insurance reasons) (nonsurgery group 1), and 321 patients who did not seek surgery (nonsurgery group 2). We performed clinical examinations at baseline and at 2 years, 6 years, and 12 years to ascertain the presence of type 2 diabetes, hypertension, and dyslipidemia. RESULTS The follow-up rate exceeded 90% at 12 years. The adjusted mean change from baseline in body weight in the surgery group was -45.0 kg (95% confidence interval [CI], -47.2 to -42.9; mean percent change, -35.0) at 2 years, -36.3 kg (95% CI, -39.0 to -33.5; mean percent change, -28.0) at 6 years, and -35.0 kg (95% CI, -38.4 to -31.7; mean percent change, -26.9) at 12 years; the mean change at 12 years in nonsurgery group 1 was -2.9 kg (95% CI, -6.9 to 1.0; mean percent change, -2.0), and the mean change at 12 years in nonsurgery group 2 was 0 kg (95% CI, -3.5 to 3.5; mean percent change, -0.9). Among the patients in the surgery group who had type 2 diabetes at baseline, type 2 diabetes remitted in 66 of 88 patients (75%) at 2 years, in 54 of 87 patients (62%) at 6 years, and in 43 of 84 patients (51%) at 12 years. The odds ratio for the incidence of type 2 diabetes at 12 years was 0.08 (95% CI, 0.03 to 0.24) for the surgery group versus nonsurgery group 1 and 0.09 (95% CI, 0.03 to 0.29) for the surgery group versus nonsurgery group 2 (P<0.001 for both comparisons). The surgery group had higher remission rates and lower incidence rates of hypertension and dyslipidemia than did nonsurgery group 1 (P<0.05 for all comparisons). CONCLUSIONS This study showed long-term durability of weight loss and effective remission and prevention of type 2 diabetes, hypertension, and dyslipidemia after Roux-en-Y gastric bypass. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others.).

中文翻译：

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胃绕道手术后12年的体重和代谢结果。

背景技术迄今为止，很少进行减肥手术的长期或对照研究。我们报告了在美国进行的Roux-en-Y胃旁路手术的一项观察性，前瞻性研究的12年随访结果。方法总共1156例严重肥胖患者分为三组：418例行Roux-en-Y胃旁路手术的患者（手术组），417例未行手术的患者（主要是出于保险原因）（非手术组1） ）和321例未进行手术的患者（非手术组2）。我们在基线以及2年，6年和12年进行了临床检查，以确定是否存在2型糖尿病，高血压和血脂异常。结果12年随访率超过90％。在2年时，手术组相对于基线的校正后平均体重变化为-45.0 kg（95％置信区间[CI] -47.2至-42.9；平均变化百分比为-35.0），-36.3 kg（95％CI） ，在6年时为-39.0至-33.5；平均百分变化为-28.0），在12年时为-35.0 kg（95％CI，-38.4至-31.7；平均百分变化为-26.9）；非手术组1在12年时的平均变化为-2.9 kg（95％CI，-6.9至1.0；平均百分比变化为-2.0），非手术组2在12年时的平均变化为0 kg（95％CI） ，-3.5至3.5；平均百分比变化，-0.9）。在手术组中，基线时患有2型糖尿病的患者中，2年时88例患者中的66例（75％），6年时87例中的54例（62％）和2例84中的43例缓解了2型糖尿病。 12岁的患者（51％）。12岁时2型糖尿病发病率的比值比为0.08（95％CI，手术组与非手术组1的差异为0.03至0.24），手术组与非手术组2的差异为0.09（95％CI，0.03至0.29）（两个比较的P <0.001）。与非手术组1相比，手术组的缓解率更高，高血压和血脂异常的发生率更低（所有比较的P <0.05）。结论本研究显示了Roux-en-Y胃绕道手术后体重减轻的长期持久性以及有效的缓解和预防2型糖尿病，高血压和血脂异常的能力。（由美国糖尿病，消化，肾脏疾病研究所及其他机构资助。）与非手术组1相比，手术组的缓解率更高，高血压和血脂异常的发生率更低（所有比较的P <0.05）。结论本研究显示了Roux-en-Y胃绕道手术后体重减轻的长期持久性以及有效的缓解和预防2型糖尿病，高血压和血脂异常的能力。（由美国糖尿病，消化，肾脏疾病研究所及其他机构资助。）与非手术组1相比，手术组的缓解率更高，高血压和血脂异常的发生率更低（所有比较的P <0.05）。结论本研究显示了Roux-en-Y胃绕道手术后体重减轻的长期持久性以及有效的缓解和预防2型糖尿病，高血压和血脂异常的能力。（由美国糖尿病，消化，肾脏疾病研究所及其他机构资助。）