■已发现超重和肥胖在校正的QT间期(QTc)中表现出统计学上的显着增加,导致猝死的主要因素。然而,广泛使用的减肥策略的影响,包括饮食,锻炼,抗肥胖药物,和QTc的减肥手术仍然不一致。因此,本系统综述和荟萃分析旨在定量分析和评价肥胖患者在采用运动干预和抗肥胖药物控制饮食后体重减轻对QTc的影响。以及减肥手术。
■20项随机对照试验(RCT)和观察性研究纳入了减重对QTc影响的荟萃分析。在随机对照试验中采用了固定效应模型,由于观察性研究中存在统计异质性,因此采用随机效应模型。进行亚组分析以了解不同体重减轻方法和随访时间的差异。
■总的来说,肥胖人群减重后的QTc比以前短(均差(MD)=21.97ms,95%置信区间(CI)=12.42,31.52,p<0.0001)。限制于7项纳入研究的亚组分析,其干预是饮食控制和运动,显示QTc降低,具有统计学意义(MD=9.35ms,95CI=2.56,37.54,p=.007)。在剩下的11项研究中,减肥手术是减肥方法。结果还显示术后QTc缩短,差异有统计学意义(MD=29.04ms,95CI=-16.46,41.62,p<.00001)。进一步观察到6个月时QTc缩短与术前相比有统计学意义的差异(MD=-31.01ms,95CI=-2.89,-59.12,p=0.03)。随访12个月时QTc的缩短与手术前也有显著差异(MD=36.47ms,95CI=14.17,58.78,p<.00001)。此外,随着随访时间的延长,差异变得更加明显.
■我们证明了减肥与QTc缩短有关,不考虑减肥的手段。已发现减重手术导致QTc的更大降低。
UNASSIGNED: Overweight and obesity have been found to exhibit a statistically significant increase in corrected QT interval (
QTc), a major contributing factor to sudden death. However, the influence of widely used weight loss strategies including diet, exercise, anti-obesity drugs, and bariatric surgery on
QTc remains inconsistent. Therefore, the present systematic
review and meta-analysis aim to quantitatively analyse and evaluate the effect of weight loss on
QTc in obese patients after diet control with exercise intervention and anti-obesity drugs, as well as bariatric surgery.
UNASSIGNED: Twenty randomised controlled trials (RCT) and observational studies were included in the meta-analysis on the effects of weight loss on QTc. The fixed-effects model was employed in the RCTs, and the random-effects model was employed due to the presence of statistical heterogeneity among observational studies. Subgroup analysis was conducted to understand the differences in distinct weight loss methods and follow-up time.
UNASSIGNED: Overall, the QTc of people with obesity after weight loss was shorter than that before (mean difference (MD) = 21.97 ms, 95% confidence interval (CI) = 12.42, 31.52, p < .0001). Subgroup analysis restricted to seven included studies whose intervention was diet control with exercise showed a decrease of QTc with statistical significance (MD = 9.35 ms, 95%CI = 2.56, 37.54, p = .007). In the remaining 11 studies, bariatric surgery was the weight loss method. The results also showed a shortening of QTc after surgery, and the difference was statistically significant (MD = 29.04 ms, 95%CI = -16.46, 41.62, p < .00001). A statistically significant difference in QTc shortening at 6 months compared to pre-operation values was further observed (MD = -31.01 ms, 95%CI = -2.89, -59.12, p = .03). The shortening of QTc at 12 months of follow-up was also significantly different from that before surgery (MD = 36.47 ms, 95%CI = 14.17, 58.78, p < .00001). Moreover, the differences became more pronounced as the follow-up time extended.
UNASSIGNED: We demonstrate that weight loss links to a shortened QTc, without considering the means of weight loss. Bariatric surgery has been found to result in a greater reduction in
QTc.