Scopinaro Nicola, Marinari Giuseppe Maria, Camerini Giovanni Bruno, Papadia Francesco Saverio, Adami Gian Franco
Department of Surgery, University of Genoa School of Medicine, Italy.
Diabetes Care. 2005 Oct;28(10):2406-11. doi: 10.2337/diacare.28.10.2406.
Gastric bypass and biliopancreatic diversion (BPD) are known to have a beneficial effect on glucose metabolism superior to that of the other bariatric operations. Thanks to its excellent weight loss results and to its specific actions, BPD has proven able to guarantee permanent normalization of serum glucose, triglyceride, and cholesterol levels in the vast majority, if not the totality, of operated patients. However, clinical studies on the duration of these effects in large patient populations are still lacking.
The files of 312 BPD obese patients with type 2 diabetes operated on from June 1984 to January 1993 were examined. Pre- and postoperative serum glucose, triglyceride, and cholesterol levels, along with arterial pressure measurements, were considered.
After BPD, fasting serum glucose concentration fell within normal values in all but two of the operated subjects and remained in the physiological range in all but six up until 10 years. Serum triglyceride and total cholesterol steadily normalized in all subjects with abnormally high preoperative values, and arterial hypertension disappeared in the vast majority of the preoperatively hypertensive patients.
BPD proved able to reverse all the major components of the metabolic syndrome in nearly all the operated subjects, with results being strictly maintained over a 10-year follow-up period. This outcome, which far exceeds those following similar weight loss at short or long term obtained by any other means, confirms the existence of specific actions of BPD on the major components of metabolic syndrome.
已知胃旁路手术和胆胰分流术（BPD）对葡萄糖代谢具有优于其他减肥手术的有益效果。由于其出色的减肥效果及其特定作用，BPD已被证明能够保证绝大多数（即使不是全部）接受手术的患者血清葡萄糖、甘油三酯和胆固醇水平永久正常化。然而，关于这些效果在大量患者群体中的持续时间的临床研究仍然缺乏。
检查了1984年6月至1993年1月期间接受手术的312例BPD肥胖2型糖尿病患者的病历。考虑了术前和术后的血清葡萄糖、甘油三酯和胆固醇水平以及动脉压测量值。
BPD术后，除两名手术对象外，所有手术对象的空腹血清葡萄糖浓度均降至正常范围内，并且在除六名对象外的所有对象中，直至10年都保持在生理范围内。术前值异常高的所有对象的血清甘油三酯和总胆固醇稳步正常化，并且绝大多数术前高血压患者的动脉高血压消失。
BPD被证明能够使几乎所有手术对象的代谢综合征的所有主要成分得到逆转，并且在10年的随访期内结果得到严格维持。这一结果远远超过通过任何其他方式在短期或长期内实现类似体重减轻后的结果，证实了BPD对代谢综合征主要成分具有特定作用。
