Søvik Torgeir T, Irandoust Babak, Birkeland Kåre I, Aasheim Erlend T, Schou Carl Fredrik, Kristinsson Jon, Mala Tom
Senter for sykelig overvekt og Gastroenterologisk kirurgisk avdeling, Oslo universitetssykehus, Aker 0514 Oslo, Norway.
Tidsskr Nor Laegeforen. 2010 Jul 1;130(13):1347-50. doi: 10.4045/tidsskr.09.0935.
Overweight and obesity are associated with an increased risk of acquiring type 2 diabetes and metabolic syndrome. We have assessed the prevalence of these conditions before and after gastric bypass surgery for morbid obesity.
The patients included had undergone laparoscopic gastric bypass at Oslo University Hospital Aker in the period 01.01.2007 - 31.12.2007 and had follow-up data for more than six months. Type 2 diabetes was defined as one or more of the following: an established diagnosis of diabetes before surgery, fasting plasma glucose >or= 7.0 mmol/l or HbA1c >or= 6.5 %. The metabolic syndrome was defined according to criteria laid out by the National Cholesterol Education Program.
136 patients (79 % women) with a mean (+/- SD) age of 43 +/- 9 years were included. Mean follow-up time was 17 months (range 8 - 26). The patients' body mass index (kg/m2) was reduced from 47 +/- 6 before to 32 +/- 6 after surgery (p<0.001). 34 % of patients had type 2 diabetes before and 10 % after surgery (p < 0.001). 80 % of patients had metabolic syndrome before and 24 % after surgery (p < 0.001). Fasting plasma glucose, HbA1c, and all variables included in the definition of metabolic syndrome were statistically significantly improved after surgery.
Gastric bypass has favourable effects on type 2 diabetes. Blood glucose normalised in most patients after the operation. The prevalence of metabolic syndrome was significantly lower after surgery.
超重和肥胖与患2型糖尿病和代谢综合征的风险增加相关。我们评估了病态肥胖患者在胃旁路手术后这些病症的患病率。
纳入的患者于2007年1月1日至2007年12月31日在奥斯陆大学医院阿克分院接受了腹腔镜胃旁路手术，且有超过6个月的随访数据。2型糖尿病定义为以下一项或多项：手术前已确诊糖尿病、空腹血糖≥7.0 mmol/l或糖化血红蛋白≥6.5%。代谢综合征根据美国国家胆固醇教育计划制定的标准定义。
纳入了136例患者（79%为女性），平均（±标准差）年龄为43±9岁。平均随访时间为17个月（范围8 - 26个月）。患者的体重指数（kg/m2）从术前的47±6降至术后的32±6（p<0.001）。术前34%的患者患有2型糖尿病，术后为10%（p < 0.001）。术前80%的患者患有代谢综合征，术后为24%（p < 0.001）。术后空腹血糖、糖化血红蛋白以及代谢综合征定义中包含的所有变量均有统计学显著改善。
胃旁路手术对2型糖尿病有良好效果。术后大多数患者血糖恢复正常。术后代谢综合征的患病率显著降低。
