Obesity Research Unit, School of Primary Care Monash University, Melbourne, Australia.
Obes Rev. 2012 Jan;13(1):57-67. doi: 10.1111/j.1467-789X.2011.00928.x. Epub 2011 Aug 31.
Bariatric surgery is becoming an accepted option for obese people with type 2 diabetes. Our aim was to assess the impact of laparoscopic adjustable gastric banding (LAGB) through a systematic review of the literature. Data was sourced from Scopus, MEDLINE and EMBASE published from 2000 through May 2011, and five unpublished studies that were performed by industry for regulatory approval were also included. Studies were selected on the basis that they provide some detail of diabetes status before and after LAGB. There were 35 studies meeting the inclusion criteria. There was considerable heterogeneity in study design, sample size, length of follow-up, attrition rates and classification of diabetes status. Weight loss was progressive over the first 2 years with a weighted average of 47% excess weight loss at 2 years. Remission or improvement in diabetes varied from 53% to 70% over different time periods. Results were broadly consistent, demonstrating clinically relevant improvements in diabetes outcomes with sustained weight loss in obese people with type 2 diabetes following LAGB surgery. However, there were significant shortcomings in the reviewed literature with few high-quality studies, inconsistent reporting of diabetes outcomes and high attrition rates. Long-term studies that address these limitations are needed.
减重手术成为肥胖 2 型糖尿病患者的一种可接受的选择。我们的目的是通过对文献的系统回顾来评估腹腔镜可调节胃束带术（LAGB）的影响。数据来源于 Scopus、MEDLINE 和 EMBASE，发表时间为 2000 年至 2011 年 5 月，还包括 5 项由行业为监管批准而进行的未发表研究。选择这些研究的依据是它们提供了 LAGB 前后糖尿病状况的一些详细信息。共有 35 项研究符合纳入标准。研究设计、样本量、随访时间、失访率和糖尿病状况分类存在很大的异质性。体重在最初的 2 年内逐渐减轻，2 年后超重体重减轻的加权平均值为 47%。不同时间段糖尿病的缓解或改善率从 53%到 70%不等。结果大致一致，表明 LAGB 手术后肥胖 2 型糖尿病患者持续减重可显著改善糖尿病结局。然而，所审查的文献存在明显的缺陷，高质量研究较少，糖尿病结局报告不一致，失访率较高。需要进行解决这些局限性的长期研究。
