Bariatric Surgery Combined With GLP-1RA: A Multicenter Study. (BS-GLP)
The Efficacy and Safety of Bariatric Surgery Combined With GLP-1 Receptor Agonists for Patients With Obesity: A Prospective, Multicenter Cohort Study
Obese patients exhibit considerable heterogeneity and complex comorbidities, making long-term effective management challenging with single therapies. While bariatric surgery remains the most effective weight-loss intervention, postoperative weight regain and metabolic deterioration require attention. GLP-1 RAs offer distinct advantages for weight and metabolic improvement, and their combined application with surgery may yield synergistic benefits.
Given the lack of multi-regional validation in China's diverse population, this multicenter study aims to confirm the real-world effectiveness and generalizability of bariatric surgery plus GLP-1RA across distinct regional cohorts.
研究概览
详细说明
"bariatric surgery is guideline-recommended as an effective obesity treatment. Substantial evidence demonstrates its ability to significantly reduce weight, improve comorbidities like type 2 diabetes (T2DM) and dyslipidemia, and lower cardiovascular risk. However, the significant heterogeneity and complex comorbidity profiles among obese patients challenge long-term effective management with single therapeutic approaches. While currently the most effective weight-loss intervention, bariatric surgery requires attention to issues such as postoperative weight regain and metabolic deterioration.
In parallel, Glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated significant efficacy in obesity management. Agents like semaglutide promote weight loss and metabolic improvement through mechanisms including insulin secretion promotion, appetite suppression, delayed gastric emptying, and enhanced satiety.
Previous single-center studies have confirmed the efficacy of this combination therapy. However, given China's vast geographic and ethnic diversity, it remains unclear whether these findings are generalizable to broader populations. This multicenter study is therefore designed to assess the real-world effectiveness and generalizability of bariatric surgery plus GLP-1RA across distinct regional cohorts in China.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Yishan Huang
- 电话号码:86+18810621201
- 邮箱:bucmyishan@163.com
学习地点
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Beijing、中国
- 招聘中
- China-Japan Friendship Hospital
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接触:
- Hua Meng
- 电话号码:86+18611457779
- 邮箱:1689024958@qq.com
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Hebei
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Xingtai、Hebei、中国
- 招聘中
- Xingtai Ninth Hospital
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接触:
- Canghui Wu
- 电话号码:86+18003192321
- 邮箱:175639863@qq.com
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Henan
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Zhengzhou、Henan、中国
- 招聘中
- Zhengzhou Central Hospita
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接触:
- Yangxi Hu
- 电话号码:86+15036088199
- 邮箱:huyangxi2046@163.com
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Inner Mongolia
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Baotou、Inner Mongolia、中国
- 招聘中
- The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology
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接触:
- Shuquan Duan
- 电话号码:86+13848539190
- 邮箱:13848539190@163.com
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Shandong
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Jinan、Shandong、中国
- 招聘中
- The Second Hospital, Cheeloo College of Medicine, Shandong University
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接触:
- Yinlu Ding
- 电话号码:86+17660081216
- 邮箱:dingyinlu@126.com
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Shanxi
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Datong、Shanxi、中国
- 招聘中
- Sinopharm Tongmei General Hospital
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接触:
- Lei Zhang
- 电话号码:86+13734222766
- 邮箱:zhanglei412625@163.com
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Yunnan
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Kunming、Yunnan、中国
- 招聘中
- The First People Hospital of Yunnan Province
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接触:
- Bian Wu
- 电话号码:86+13987172118
- 邮箱:6026170@qq.com
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参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
- Primary metabolic surgery candidates: Patients undergoing initial laparoscopic sleeve gastrectomy (LSG).
- obesity:BMI ≥27.5 kg/m².
- Metabolic comorbidities: Diagnosis of metabolic syndrome or type 2 diabetes mellitus (T2DM) meeting standard criteria.
- Age range: 16-70 years (inclusive).
- Informed consent: Willing participation with documented consent.
Exclusion Criteria:
- Recent GLP-1RA use: Treatment with GLP-1 receptor agonists within 6 months preoperatively.
- Prior bariatric surgery: History of any metabolic/bariatric surgical procedure.
- Postoperative complications: Requiring reoperation for severe complications (e.g., hemorrhage, anastomotic leak).
- Non-indicated candidates: Patients not meeting standard bariatric surgery indications.
- Significant comorbidities:
Advanced hepatic/renal dysfunction (Child-Pugh C or eGFR <30 mL/min/1.73m²) Active malignancy (except non-melanoma skin cancers) Autoimmune disorders requiring immunosuppression Uncontrolled psychiatric conditions (e.g., active psychosis, severe depression)
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:非随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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其他:BS 组
手术名称:腹腔镜袖状胃切除术。
药物名称:不适用。
观察组:术后仅接受基础营养建议干预。
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1.Basic Treatment Measures Within 0-30 days after sleeve gastrectomy, all patients received very low-calorie enteral nutrition powder (100 kcal/day).
From 30 to 90 days post-surgery, a low-energy diet (400 kcal/day) was provided.
Beyond 90 days post-surgery, a calorie-restricted diet was implemented (1,500 kcal/day for men and 1,200 kcal/day for women).
2.Observation Group: Received only basic nutritional recommendation interventions after surgery.
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实验性的:BS-GLP1RA group
Names for Surgery: Laparoscopic Sleeve Gastrectomy.
Names for drugs: Semaglutide.
Dosage:The starting dose was 0.25 mg per week and was subsequently titrated up based on individual patient response to a maximum maintenance dose of 2.4 mg per week.
Frequency: Once per week.
Duration: The treatment continued until the completion of the 6-month postoperative period.
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1.Basic Treatment Measures Within 0-30 days after sleeve gastrectomy, all patients received very low-calorie enteral nutrition powder (100 kcal/day).
From 30 to 90 days post-surgery, a low-energy diet (400 kcal/day) was provided.
Beyond 90 days post-surgery, a calorie-restricted diet was implemented (1,500 kcal/day for men and 1,200 kcal/day for women).
2.In addition to laparoscopic sleeve gastrectomy and postoperative basic nutritional counseling,the intervention group received subcutaneous semaglutide injections from 1 to 6 months postoperatively.The specific protocol was as follows:In the intervention group, semaglutide treatment was initiated at 1 month after LSG.
The starting dose was 0.25 mg per week and was subsequently titrated up based on individual patient response to a maximum maintenance dose of 2.4 mg per week.
The treatment continued until the completion of the 6-month postoperative period.
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
|---|---|
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the Percentage of weight loss
大体时间:1 year
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1 year
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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体重(公斤)
大体时间:术后立即(第0天),以及术后1、3、6和12个月。
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术后立即(第0天),以及术后1、3、6和12个月。
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腰围(厘米)
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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血压
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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血清肌酐
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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肾小球滤过率
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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空腹血糖
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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餐后2小时血糖
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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糖化血红蛋白
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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总胆固醇
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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低密度脂蛋白(LDL)
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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高密度脂蛋白(HDL)
大体时间:术后立即(第0天),以及术后1、3、6和12个月。
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术后立即(第0天),以及术后1、3、6和12个月。
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甘油三酯
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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丙氨酸氨基转移酶(ALT)
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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天冬氨酸氨基转移酶(AST)
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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尿酸(UA)
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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其他结果措施
结果测量 |
大体时间 |
|---|---|
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肌肉质量(千克)
大体时间:术后即刻(第 0 天),以及术后 1、3、6 和 12 个月。
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术后即刻(第 0 天),以及术后 1、3、6 和 12 个月。
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内脏脂肪面积
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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体脂率
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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体脂率(BFP)
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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去脂体重(LBM)
大体时间:术后立即(第0天),以及术后1、3、6和12个月。
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术后立即(第0天),以及术后1、3、6和12个月。
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瘦体重百分比(LBMP)
大体时间:术后即刻(第0天),以及术后1、3、6和12个月。
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术后即刻(第0天),以及术后1、3、6和12个月。
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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