mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/issn2072-3180.2020.2.63-78mossj-408Research ArticleБАРИАТРИЧЕСКАЯ ХИРУРГИЯBARIATRIC SURGERYИЗУЧЕНИЕ ВЛИЯНИЯ БАРИАТРИЧЕСКОЙ ХИРУРГИИ НА ПРОДОЛЖИТЕЛЬНОСТЬ ЖИЗНИ ПАЦИЕНТОВ С МЕТАБОЛИЧЕСКИМ СИНДРОМОМTHE IMPACT OF BARIATRIC SURGERY ON LIFE EXPECTANCY IN PATIENTS WITH METABOLIC SYNDROMEОспановО. Б.OspanovO. B.

Оспанов Орал Базарбаевич, проф., д.м.н., главный исследователь исследовательского проекта AP05135241 Университетского медицинского центра;

профессор кафедры хирургических болезней и бариатрической хирургии Медицинского университета Астана, Нур-Султан

г. Нур-Султан, 010000. улица Бейбитшилик 49а

Ospanov Oral Bazarbaevich, prof., MD, chief researcher of the research project AP05135241 of the University Medical Center;

Professor of the Department of Surgical Diseases and Bariatric Surgery, Astana Medical University

NurSultan, 010000. 49a Beibitshilik street

bariatric.kz@gmail.comАкилжановаА. Р.AkilzhanovaA. R.

Акильжанова Айнур Рахметуловна, проф., д.м.н., руководитель

Нур-Султан, 010000, пр. Кабанбай батыра 53

Akilzhanova Ainur Rakhmetulovna, prof., MD, head

Nur-Sultan, 010000, 53 Kabanbai batyr ave

akilzhanova@nu.edu.kzБекмурзиноваФ. К.BekmurzinovaF. K.

Бекмурзинова Фарида Кайратовна, клинический ординатор кафедры, НАО «МУА»

Нур-Султан, 010000. улица Бейбитшилик 49а

Bekmurzinova Farida Kairatovna, clinical resident of the department, NJSC “MUA”

Nur-Sultan, 010000. 49a Beybitshilik street

farida.bariatric@gmail.comРахимоваС. Е.RakhimovaS. E.

Рахимова Сауле Есламовна, к.б.н., сотрудник

Нур-Султан, 010000, пр. Кабанбай батыра 53

Rakhimova Saule Eslamovna, candidate of biological sciences, employee

Nur-Sultan, 010000, 53 Kabanbai batyr ave

Saule.rakhimova@nu.edu.kzЕлеуовГ. А.EleuovG. A.

Елеуов Галымжан Алмасбекович, к.м.н., член исследовательской группы КФ «UMC» по грантовому научному проекту МОН РК №AP05135241

Нур-Султан, 010000, пр. Кабанбай батыра 53

Eleuov Galymzhan Almasbekovich, Ph.D., a member of the research group of the KF “UMC” under the grant scientific project of the Ministry of Education and Science of the Republic of Kazakhstan No. AP05135241

Nur-Sultan, 010000, Kabanbai batyr ave. 53

g.eleuov@mail.ruКожамкуловУ. А.KozhamkulovU. A.

Кожамкулов Улан Анетович, к.м.н., сотрудник

Нур-Султан, 010000, пр. Кабанбай батыра 53

Ulan Anetovich Kozhamkulov, Ph.D., employee

Nur-Sultan, 010000, 53 Kabanbai batyr ave

Ulan.kozhamkulov@nu.edu.kzАбдинаЖ. Д.AbdinaZ. D.

Абдина Жанар Давлетовна, магистр медицинский наук, член исследовательской группы КФ «UMC» по грантовому научному проекту МОН РК №AP05135241

Нур-Султан, 010000, пр. Кабанбай батыра 53

Abdina Zhanar Davletovna, Master of Medicine, member of the research group of the KF “UMC” on the grant scientific project of the Ministry of Education and Science of the Republic of Kazakhstan No. AP05135241

Nur-Sultan, 010000, 53 Kabanbai batyr ave

abdina@bmc.mcudp.kzФурсовР. А.FursovR. A.

Фурсов Роман Александрович, к.м.н., доцент кафедры лапароскопической и бариатрической хирургии, НАО «МУА»

Нур-Султан, 010000. улица Бейбитшилик 49а

Fursov Roman Aleksandrovich, Candidate of Medical Sciences, Associate Professor of the Department of Laparoscopic and Bariatric Surgery, NJSC “MUA”

Nur-Sultan, 010000. 49a Beybitshilik street

fursrom@mail.ruИсследовательская группа «University Medical Center» (UMC); Кафедра хирургических болезней и бариатрической хирургии, НАО «Медицинский университет Астана»КазахстанResearch Group of University Medical Center, UMCЖ Dept. of Laparoscopic and Bariatric Surgery, Astana Medical UniversityKazakhstanЛаборатория Геномной и Персонализированной Медицины «Национальная Лаборатория Астана» Назарбаев УниверситетаКазахстанLaboratory of Genomic and Personalized Medicine, National Laboratory Astana, Nazarbayev UniversityKazakhstanКафедра хирургических болезней и бариатрической хирургии, НАО «Медицинский университет Астана»КазахстанDept. of Laparoscopic and Bariatric Surgery, Astana Medical UniversityKazakhstanИсследовательская группа «University Medical Center» (UMC)КазахстанResearch Group of University Medical Center, UMCKazakhstan202025122020036378Copyright © Оспанов О.Б., Акилжанова А.Р., Бекмурзинова Ф.К., Рахимова С.Е., Елеуов Г.А., Кожамкулов У.А., Абдина Ж.Д., Фурсов Р.А., 20202020Оспанов О.Б., Акилжанова А.Р., Бекмурзинова Ф.К., Рахимова С.Е., Елеуов Г.А., Кожамкулов У.А., Абдина Ж.Д., Фурсов Р.А.Ospanov O.B., Akilzhanova A.R., Bekmurzinova F.K., Rakhimova S.E., Eleuov G.A., Kozhamkulov U.A., Abdina Z.D., Fursov R.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/408

Введение: по литературным данным, между длиной теломер хромосом как предиктора продолжительности жизни и ожирением с метаболическими проявлениями выявлена корреляционная связь. Целью данного исследования была оценка изменения длины теломер как показателя продолжительности жизни, изменения массы тела и других компонентов метаболического синдрома после хирургической и нехирургической потери массы тела. Методы: исследование разработано как интервенционное, проспективное, контролируемое, рандомизированное с 60 участниками, разделенными на три группы. В первую группу вошли пациенты, перенесшие лапароскопическое одноанастомозное шунтирование желудка с обструктивным созданием пауча и анастомоза (ЛОАГШ-ОСПАН). Пациентам второй группы было выполнено стандартное лапароскопическое мини-гастрошунтирование (ЛМГШ-ОАГШ). Пациенты третьей группы получали нехирургическую терапию по снижению массы тела, включающую гипокалорийную диету. Оценивали изменение длины теломер лейкоцитов и регресс показателей индекса массы тела, а также изменения в показателях компонентов метаболического синдрома. Результаты: были отобраны 96 потенциальных участников, из которых впоследствии 60 были рандомизированы и распределены для исследования: группа ЛОАГШ-ОСПАН (n = 20), группа ЛМГШ-ОАГШ (n = 20), консервативная группа (n = 20). В хирургических группах (ЛОАГШ-ОСПАН, ЛМГШ-ОАГШ) через 12 месяцев после операции была самая большая потеря веса по сравнению с консервативной группой со средними изменениями ИМТ -12,13 (-8,34; -15,93); -16,04 (-11,7; 20,37) и -2,76 (-3,84; -9,36) от исходного уровня, соответственно в первой и второй группах (p<0,01). Также в хирургических группах было наиболее значительное изменение длины теломер: 2,02 (1,61; 2,41); 2,07 (1,72; 2,43); и 0,28 (0,22; 0,78) от исходного уровня, соответственно в первой и второй группах (p <0,001). Заключение: по сравнению с нехирургическим лечением пациентов с ожирением и метаболическим синдромом, бариатрическая хирургия приводит к большей потере массы тела, при этом достигается более значительное увеличение длины теломер и наблюдается большая степень разрешения проявлений метаболического синдрома.

Introduction: A correlation was found between the length of chromosome telomeres as a predictor of life expectancy and obesity with metabolic manifestations. The aim of this study was to evaluate the changes of telomere length as an indicator of life expectancy, changes in body mass and other components of the metabolic syndrome after weight loss. Methods: the study is designed as an interventional, prospective, controlled, a three-arm randomized controlled trial at a single center including 60 participants. The first group is composed of patients who have undergone stapleless laparoscopic one anastomosis gastric bypass with an obstructive stapleless pouch and anastomosis. The second group of patients underwent staple use laparoscopic mini-gastric bypass-one anastomosis gastric bypass. The patients in the third group received non-surgical weight loss therapy, including a hypocaloric diet with energy restriction. Primary outcome measures included changes in the length of leukocyte telomeres. Secondary outcome measurements included changes in body mass index, other components of the metabolic syndrome. Results: 60 patients were randomized and allocated for intervention: first group (n=20), second group (n=20), third group (n=20). The surgical groups (first, second) after 12 months postop had the greatest weight loss compared to third group with average changes BMI. The surgical groups also had the most significant change in telomere length. Conclusions: Compared with the non-surgical treatment of obese patients with metabolic syndrome, bariatric surgery leads to greater body weight loss and a significant increase in telomere length and greater resolved metabolic syndrome.

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The authors declare that there are no conflicts of interest present.