ADOLESCENT BARIATRICS ASSESSING HEALTH BENEFITS AND RISKS

青少年肥胖症患者评估健康益处和风险

• 批准号: 8356702
• 负责人: MARY L BRANDT
• 金额: $ 2.1万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356702
• 关键词: Adolescence; Adolescent; Adult; Affect; American; Ancillary Study; Bariatrics; Benefits and Risks; Body Weight decreased; Characteristics; Clinical; Clinical Research; Comorbidity; Data Collection; Eating Behavior; Functional disorder; Funding; Future; Genetic; Goals; Grant; Health; Health Benefit; Hypertriglyceridemia; Hypertrophy; Impairment; Insulin Resistance; Lead; Life; Life Cycle Stages; Liver; Medical; Mental Health; Metabolic; Metabolic Diseases; Morbid Obesity; Myocardial; National Center for Research Resources; National Institute of Diabetes and Digestive and Kidney Diseases; Nutritional; Obesity; Obstructive Sleep Apnea; Operative Surgical Procedures; Outcome; Plasma; Postoperative Period; Principal Investigator; Quality of life; Recruitment Activity; Regimen; Relative (related person); Research; Research Infrastructure; Research Project Grants; Resources; Risk; Safety; Sleep Apnea Syndromes; Source; Teenagers; Time; Tissues; United States National Institutes of Health; Weight; Whole Blood; Youth; age related; bariatric surgery; base; clinical decision-making; cohort; cost; depressive symptoms; experience; indexing; psychosocial

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. ABSTRACT To facilitate and accelerate research in Bariatric Surgery, the National Institute of Diabetes & Digestive, and Kidney Diseases (NIDDK) established the Longitudinal Assessment of Bariatric Surgery consortium (LABS). The LABS research project, as originally conceived, focused only on adult subjects undergoing bariatric surgery. However, an ancillary studies mechanism was also established to support other related research projects. Teen-LABS is one such related project. The primary goal of this observational Teen-LABS study is to collect baseline characteristics and postoperative outcomes of adolescents who are undergoing bariatric surgery in an effort to assess safety and efficacy of bariatric surgery. By mirroring LABS data collection, the Teen-LABS study will also allow us to estimate the relative merits of early surgery compared to delayed surgery for extremely obese youth. This comparison will lead to a better understanding of the plasticity of important medical and psychosocial obesity-related comorbidities. Moreover, this study will provide critical scientific information to inform clinical decision-making regarding appropriate timing of bariatric surgery. I. HYPOTHESIS Severe obesity in adolescence is associated with medical and psychosocial impairments which may be more effectively treated with surgery during adolescence rather than later in adulthood. II. SPECIFIC AIMS Specific Aim 1: To determine whether health significantly differs between adolescents and adults seeking bariatric surgery and thereby determine whether there are potential age-related health benefits in performing bariatric surgery earlier rather than later in the lifetime. Specific Aim 2: To identify early (30 day) and intermediate term (1-2 year) health risks for adolescents and adults undergoing bariatric surgery. Specific Aim 3: To document the psychosocial status of adolescents and adults with extreme obesity before bariatric surgery and 1 and 2 years after surgery. Psychosocial status will be examined in three major domains: depressive symptoms, eating behaviors, and quality of life. Specific Aim 4: To obtain and store biospecimens (serum, plasma, whole blood, and liver tissue) for research related to the aims of this study, and for future use by this consortium and ancillary studies for research into the pathophysiology and genetics of obesity and obesity related issues. III. BACKGROUND AND SIGNIFICANCE Bariatric surgery is effective in treating extreme obesity in adults, and is most commonly used in the 5th decade of life. As more adolescents develop extreme obesity and seek bariatric surgery, our long term goal is to elucidate the health benefits and risks of surgical weight loss for adolescents. Our central hypothesis is that severe obesity in adolescence is associated with medical and psychosocial impairments which may be more effectively treated with surgery during adolescence rather than later in adulthood. This is based on our clinical observations that adolescents undergoing bariatric surgery 1) present with clinically occult manifestations of metabolic disease and have already developed significant health and psychosocial problems which are likely to worsen, 2) lose significant weight following bariatric surgery, and 3) experience significant improvement of a number of serious obesity-related conditions such as insulin resistance, myocardial hypertrophy, hypertriglyceridemia, and obstructive sleep apnea, depressive symptoms, and quality of life. However, compliance by adolescents with prescribed medical regimens may be limited and thus may adversely affect nutritional outcomes of bariatric surgery performed in adolescence. Thus, the purpose of this study is to elucidate for the first time the benefits and define complications for bariatric surgery performed in adolescence compared to the more standard approach of performing bariatric surgery in adulthood. Our Specific Aims are: 1) To determine whether health significantly differs between adolescents and adults seeking bariatric surgery and determine whether there is an age-related health benefit in performing bariatric surgery earlier rather than later in the lifetime; 2) To identify complications to be expected for adolescents and adults undergoing bariatric surgery; 3) To document the psychosocial status of adolescents and adults with extreme obesity before and after bariatric surgery. Adolescents will be recruited from several adolescent bariatric centers and a comparison cohort of adults will be recruited from adult bariatric centers participating in the Longitudinal Assessment of Bariatric Surgery (LABS). By comparison of key anthropometric features, metabolic features, sleep apnea indices, complications, nutritional and psychosocial status, we will begin to understand medical and psychological health outcomes of bariatric surgery using obesity duration as a moderating variable. This information will scientifically inform clinical decision-making regarding appropriate timing of surgery in the life-course of Americans whose health is increasingly threatened by extreme obesity.

该副本是利用资源的众多研究子项目之一 由NIH/NCRR资助的中心赠款提供。对该子弹的主要支持 而且，副投影的主要研究员可能是其他来源提供的 包括其他NIH来源。 列出的总费用可能 代表subproject使用的中心基础架构的估计量， NCRR赠款不直接向子弹或副本人员提供的直接资金。 抽象的 为了促进和加速减肥手术的研究，美国国家糖尿病与消化研究所以及肾脏疾病（NIDDK）建立了减肥手术联盟（LABS）的纵向评估。最初构思的实验室研究项目仅着眼于接受减肥手术的成年受试者。但是，还建立了辅助研究机制，以支持其他相关研究项目。青少年lab是一个相关的项目。这项观察性青少年研究的主要目的是收集正在接受减肥手术的青少年的基线特征和术后结局，以评估减肥手术的安全性和功效。通过镜像实验室的数据收集，与极度肥胖的青年相比，与延迟手术相比，Teen-LABS研究还可以估算早期手术的相对优点。这种比较将使人们对重要的医学和社会心理肥胖相关合并症的可塑性有更好的了解。此外，这项研究将提供关键的科学信息，以告知有关适当的减肥手术时间的临床决策。 I.假设 青春期严重的肥胖与医学和社会心理障碍有关，这些障碍可能会在青春期而不是成年后更有效地通过手术治疗。 ii。 具体目标 具体目标1：确定青少年和寻求减肥手术的成年人之间的健康是否有显着不同，从而确定在早期进行减肥手术而不是一生中是否有潜在的与年龄相关的健康益处。 具体目标2：确定青少年和成年人接受减肥手术的早期（30天）和中期（1-2年）的健康风险。 特定目的3：记录青少年和成年人在减肥手术前的极端肥胖症以及手术后1和2年的心理社会心理状况。心理社会地位将在三个主要领域进行检查：抑郁症状，饮食行为和生活质量。 具体目的4：用于获得与本研究目的有关的研究，以获取和存储生物种子（血清，血浆，全血和肝组织），以及该财团和辅助研究的未来使用，用于研究肥胖和肥胖相关问题的病理生理学和遗传学。 iii。 背景和意义 减肥手术可有效治疗成年人的极端肥胖症，并且最常用于生命的第五个十年。随着越来越多的青少年发展极端肥胖并寻求减肥手术，我们的长期目标是阐明青少年的健康益处和手术减肥的风险。我们的中心假设是，青春期的严重肥胖与医学和社会心理障碍有关，这些障碍可能会在青春期而不是成年后更有效地通过手术治疗。 This is based on our clinical observations that adolescents undergoing bariatric surgery 1) present with clinically occult manifestations of metabolic disease and have already developed significant health and psychosocial problems which are likely to worsen, 2) lose significant weight following bariatric surgery, and 3) experience significant improvement of a number of serious obesity-related conditions such as insulin resistance, myocardial hypertrophy, hypertriglyceridemia, and阻塞性睡眠呼吸暂停，抑郁症状和生活质量。但是，有规定医疗方案的青少年的依从性可能受到限制，因此可能会对青春期进行的减肥手术的营养结局产生不利影响。因此，这项研究的目的是首次阐明与成年后的减肥手术的更标准方法相比，在青春期进行的益处并定义了青春期手术的并发症。我们的具体目的是：1）确定青少年和寻求减肥手术的成年人之间的健康是否有显着差异，并确定在早期进行减肥手术而不是一生中是否有与年龄相关的健康益处； 2）确定接受减肥手术的青少年和成年人的并发症； 3）记录减肥手术前后具有极端肥胖症的青少年和成年人的社会心理状况。青少年将从几个青少年的减肥中心招募，并将从参加减肥手术纵向评估（LABS）的成人减肥中心招募成人比较。通过比较关键的人体测量特征，代谢特征，睡眠呼吸暂停指数，并发症，营养和心理社会状况，我们将使用肥胖期限作为调节变量来理解减肥手术的医学和心理健康结果。这些信息将科学地为临床决策提供有关在健康越来越受到极端肥胖威胁的美国人生活过程中的适当手术时间的临床决策。