Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy: a case-matched study

被引:39
|
作者
Cheskin, Lawrence J. [1 ,3 ,7 ]
Hill, Christine [1 ]
Adam, Atif [2 ]
Fayad, Lea [2 ]
Dunlap, Margo [3 ]
Badurdeen, Dilhana [3 ]
Koller, Kristen [3 ]
Bunyard, Linda [1 ]
Frutchey, Robin [1 ]
Al-Grain, Haitham [4 ]
Kahan, Scott [5 ]
Hedjoudje, Abdellah [6 ]
Khashab, Mouen A. [3 ]
Kalloo, Anthony N. [3 ]
Kumbhari, Vivek [3 ]
机构
[1] Johns Hopkins Bloomberg Sch Publ Hlth, Johns Hopkins Weight Management Ctr, Dept Hlth Behav & Soc, Baltimore, MD USA
[2] Johns Hopkins Bloomberg Sch Publ Hlth, US Dept Int Hlth, Baltimore, MD USA
[3] Johns Hopkins Med Inst, Dept Med, Div Gastroenterol & Hepatol, Baltimore, MD 21205 USA
[4] Johns Hopkins Med Inst, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21205 USA
[5] Natl Ctr Weight & Wellness, Washington, DC USA
[6] CHRU Jean Minjoz, Fac Med Franche Comte, Besancon, France
[7] George Mason Univ, Dept Nutr & Food Studies, Coll Hlth & Human Serv, Fairfax, VA 22030 USA
关键词
BODY-MASS INDEX; WEIGHT-LOSS; BARIATRIC SURGERY; OBESITY; MORTALITY; ASSOCIATION; HEALTH;
D O I
10.1016/j.gie.2019.09.029
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aims: Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive bariatric procedure. This study compared weight loss in patients undergoing ESG with that of matched patients undergoing high-intensity diet and lifestyle therapy (HIDLT). Methods: In this case-matched study, patients were matched 2/3:1 (HIDLT/ESG) by age, sex, and body mass index (BMI). One hundred five patients (30 men) who underwent ESG thorn low-intensity diet and lifestyle therapy (LIDLT) between 2016 and 2018 were compared with 281 patients (92 men) who underwent HIDLT at the Johns Hopkins Medical Institutions from 2013 to 2014. Weight was evaluated 1, 3, 6, and 12 months after beginning HIDLT or post-ESG to determine the mean percent total body weight loss (%TBWL). Results: Mean age across both cohorts was 48.0 +/- 12.1, and baseline BMI was 40.0 +/- 7.7 kg/m(2). In multivariable analysis controlling for age, sex, and baseline BMI, the mean %TBWL at 1, 3, 6, and 12 months was significantly higher in patients undergoing ESG than matched patients undergoing HIDLT. Specifically, at 3 months, the mean %TBWL in the ESG cohort was 14.0% compared with 11.3% in the HIDLT cohort (P < .011), and at 12 months the mean %TBWL in the ESG cohort was 20.6% versus 14.3% in the HIDLT cohort (P < .001). ESG patients with baseline BMI <= 40 kg/m(2) continued to show significantly greater %TBWL than those of the same BMI group in the HIDLT group at 1, 3, 6, and 12 months after intervention (3 months, coefficient = 3.43 [P < .001]; 12 months, coefficient = 8.14 [P <.001]). Conclusions: Through 12 months of follow-up, patients who underwent ESG achieved significantly greater weight loss than patients enrolled in HIDLT. ESG appears to be a valuable alternative for patients who experience difficulty complying with HIDLT.
引用
收藏
页码:342 / +
页数:9
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