LINEA ALBA COLLAGEN ASSESSMENT IN MORBIDLY OBESE PATIENTS

ABSTRACT Background: The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy. Aim: To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers. Methods: Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group). The samples were collected in 2013 and 2104, and were sorted according to age (18-30, 31-45 and 46-60), gender, BMI, waist and cervical circumference, and subcutaneous tissue thickness. Material for biopsy was collected from the supraumbilical region of the linea alba for immunohistochemical analysis differentiating collagen type 1 and type 3 and the 1/3 ratio. Image-Pro Plus pixel counting software was used to measure the amount of collagen. Results: The obesity group evidenced mean age 44.11±9.90 years; 18-30 age group had three (6.8%) obese individuals; 31-45 had 22 (50%) and 46-60 had 19 (43.1%). Females were present in 81.8% (n=36); BMI (kg/m²) was 48.81±6.5; waist circumference (cm) was 136.761±13.55; subcutaneous tissue thickness (cm) 4.873±0.916. Considering age groups, gender and BMI, there were statistical differences in all tests when compared with the cadavers. Conclusion: The amount of collagen in the linea alba above the umbilical region in the morbidly obese patients was smaller than in the non-obese cadavers in the same age group.【摘要】 背景：腹壁胶原蛋白的相关研究日益受到关注，因其与剖腹术后愈合过程中的胶原蛋白变化息息相关。 目的：评估接受开腹减重手术患者腹白线（linea alba）处的胶原蛋白含量，并与非肥胖尸体样本进行对比。 方法：本研究共纳入44例肥胖患者（肥胖组）与44例非肥胖尸体（对照组）的88份腹部腹白线腱膜样本。样本采集于2013年及2104年（原文疑为笔误，应为2014年），并按照年龄（18~30岁、31~45岁及46~60岁）、性别、体重指数（BMI）、腰围、颈围及皮下组织厚度进行分组。从腹白线脐上区域获取活检材料，用于免疫组化分析，以区分Ⅰ型胶原蛋白（collagen type 1）与Ⅲ型胶原蛋白（collagen type 3），并计算二者的1/3比值。采用Image-Pro Plus像素计数软件测量胶原蛋白含量。 结果：肥胖组患者的平均年龄为44.11±9.90岁；其中18~30岁组有3例肥胖者，占比6.8%；31~45岁组有22例，占比50%；46~60岁组有19例，占比43.1%。女性占比81.8%（n=36）；体重指数（BMI）为48.81±6.5 kg/m²；腰围为136.76±13.55 cm；皮下组织厚度为4.873±0.916 cm。相较于对照组尸体样本，按年龄、性别及体重指数分组的各项检测均存在统计学差异。 结论：病态肥胖患者脐上区域腹白线处的胶原蛋白含量，低于同年龄段非肥胖尸体的对应样本。