Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia.
Diab Vasc Dis Res. 2013 Nov;10(6):514-9. doi: 10.1177/1479164113498083. Epub 2013 Aug 22.
To determine the effects of laparoscopic adjustable gastric banding (LAGB) on albuminuria in patients with obesity, type 2 diabetes mellitus (T2DM) and established diabetic nephropathy.
A retrospective analysis of clinical records from a tertiary diabetes service identified obese patients with T2DM who had micro- or macroalbuminuria prior to LAGB surgery. Clinical data from follow-up appointments including albuminuria were analysed.
A total of 23 T2DM patients were included in the final study. Of 7 patients with macroalbuminuria at baseline, 2 reverted to normoalbuminuria, 2 reverted to microalbuminuria and 3 remained with macroalbuminuria on their final recording in the 36-month period of follow-up. Of 16 patients with microalbuminuria, 9 reverted to normoalbuminuria, while 6 remained with microalbuminuria.
This study demonstrates significant improvements in albuminuria in patients with established diabetic nephropathy following LAGB. These results suggest the potential for LAGB to improve or reverse renal damage in patients with T2DM.
探讨腹腔镜可调节胃束带术(LAGB)对肥胖合并 2 型糖尿病(T2DM)及已确诊糖尿病肾病患者蛋白尿的影响。
对某三级糖尿病专科就诊的肥胖合并 T2DM 且存在微量或大量白蛋白尿的患者进行回顾性临床数据分析,分析其 LAGB 术前及随访过程中的白蛋白尿等临床数据。
最终共有 23 例 T2DM 患者纳入本研究。在基线时存在大量白蛋白尿的 7 例患者中,2 例白蛋白尿恢复正常,2 例恢复为微量白蛋白尿,3 例在 36 个月的随访期间最后一次记录中仍存在大量白蛋白尿。在 16 例微量白蛋白尿患者中,9 例白蛋白尿恢复正常,6 例仍存在微量白蛋白尿。
本研究表明 LAGB 可显著改善已确诊糖尿病肾病患者的蛋白尿。这些结果提示 LAGB 可能改善或逆转 T2DM 患者的肾脏损害。