Abstract: To summarize the metabolic and bariatric surgery cases performed in multiple regions of China in 2024. Methods    Based on the data registration work of the Greater China Metabolic and Bariatric Surgery Database (GC-MBD), this registry report evaluate the prevalence of metabolic and bariatric surgery in multiple regions of China, as well as the follow-up data from 2018 to 2024. Demographic characteristics, obesity-related diseases, surgery information and follow-ups data were statistically described and analyzed. Results    In 2024, 68 centers from 24 provinces/province-level municipalities in China registered a total of 7 762 valid cases to GC-MBD. The patients’ median (minimum, maximum) BMI before the surgery was 38.6 (25.1, 82.1). The cases of female patients were 5 463 (70.5%), with median (minimum, maximum) age of 33 (12, 69) years, while the cases of male patients were 2 283 (29.5%), with median (minimum, maximum) age of 32 (10, 69) years. Among all valid cases, 22.1% of patients had history of type 2 diabetes, 90.5% of patients had history of fatty liver disease, 50.7% of patients had history of hypertension, 53.1% of patients had obstructive sleep apnea syndrome (OSAS), and 17.1% of female patients had history of polycystic ovary syndrome (PCOS). Among all procedures, 87.60% were sleeve gastrectomy (SG), 3.59% were sleeve gastrectomy with transit bipartition (SG-TB), 3.43% were Roux-en-Y gastric bypass (RYGB), 2.56% were one anastomosis gastric bypass (OAGB), 2.14% were sleeve gastrectomy with jejuno-jenunal bypass (SG-JJB), 0.44% were single-anastomosis duodenal-ileal bypass with sleeve gastrectomy/one anatomosis duodenal switch (SADI-S/OADS), 0.05% were sleeve gastrectomy with duodenojejunal bypass (SG-DJB), 0.01% were sleeve gastrectomy with loop duodenojejunal bypass (SG-LDJB), and 0.18% were other operation types. There were significant differences in the trends of excess weight loss rate (%EWL) and total weight loss rate (%TWL) over time among different obesity severity groups (mild, moderate, severe, and very severe) (P=0.004, P<0.001). Conclusion    Based on the analysis of the 2024 registry report, patients who underwent metabolic and bariatric surgery in China are mainly middle-aged and young, with a majority of female patients and a high proportions of obesity-related diseases before surgery. SG still is the mainstream surgical procedure in China. The weight loss level in the mid-to-long term after surgery is significant, with differential characteristics observed among different severities of obesity. The 2024 registry report reflects the disciplinary development trends of metabolic and bariatric surgery in China, providing an important basis for comparison with previous annual and international data.

Key words: metabolic and bariatric surgery, clinical database, registry report, obesity

摘要： 目的    统计分析中国多地区2024年度减重与代谢手术开展情况。方法    基于大中华减重与代谢手术数据库数据登记工作，统计分析2024年度各地区开展减重与代谢手术情况以及2018-2024年度随访情况，并对病人人口学信息、肥胖相关疾病、手术信息、随访信息等进行统计学描述和分析。结果    2024年度，来自24个省、自治区及直辖市共68家中心上传临床数据至大中华减重与代谢手术数据库，登记有效病例7762例。术前体重指数（BMI）为38.6（25.1，82.1）。女性病人5463例（70.5%），年龄33（12，69）岁；男性病人2283例（29.5%），年龄32（10，69）岁。在所有有效病例中，22.1%的病人在术前合并2型糖尿病，90.5%合并代谢相关性脂肪性肝病，50.7%合并高血压，53.1%合并阻塞型睡眠呼吸暂停综合征，17.1%的女性病人术前合并多囊卵巢综合征。手术方式方面，胃袖状切除术（SG）占87.60%，胃袖状切除联合双通道术（SG-TB）占3.59%，Roux-en-Y胃旁路术（RYGB）占3.43%，单吻合口胃旁路术（OAGB）占2.56%，胃袖状切除联合空肠空肠旁路术（SG-JJB）占2.14%，胃袖状切除联合单吻合口十二指肠回肠旁路术/单吻合口十二指肠转位术（SADI-S/OADS）占0.44%，胃袖状切除联合十二指肠空肠旁路术（SG-DJB）占0.05%，胃袖状切除联合袢式十二指肠空肠旁路术（SG-LDJB）占0.01%，其他手术方式占0.18%。2018-2024年度随访信息显示，不同肥胖症分级（轻度、中度、重度、极重度）组间多余体重减少率（%EWL）与总体重减少率（%TWL）随时间变化趋势差异有统计学意义（P=0.004，P<0.001）。结论    通过对2024年度数据报告分析，中国接受减重与代谢手术病人主要以中青年为主，女性病人居多，术前合并肥胖相关疾病占比高，SG仍为主流术式。术后中长期减重水平显著，不同肥胖症程度术后结局存在差异特征。2024年度报告研究反映了中国减重与代谢外科学科发展动态，为与既往年度数据、国际数据对比提供了重要基础。

关键词: 减重与代谢手术, 数据库, 年度报告, 肥胖