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腹腔镜单吻合口胃旁路术(LSAGB)治疗低体重指数(<30 kg/m²)2型糖尿病患者的短期疗效

Short-term outcomes of laparoscopic single anastomosis gastric bypass (LSAGB) for the treatment of type 2 diabetes in lower BMI (<30 kg/m(2)) patients.

作者信息

Kim Myung Jin, Hur Kyung Yul

机构信息

Department of Surgery, Soonchunhyang University College of Medicine, 59, Daesagwan-ro (657, Hannam-dong), Yongsan-gu, Seoul, South Korea.

出版信息

Obes Surg. 2014 Jul;24(7):1044-51. doi: 10.1007/s11695-014-1202-5.

Abstract

BACKGROUND

Bariatric surgery is an efficient procedure for remission of type 2 diabetes (T2DM) in morbid obesity. However, in Asian countries, mean body mass index (BMI) of T2DM patients is about 25 kg/m(2). Various data on patients undergoing gastric bypass surgery showed that control of T2DM after surgery occurs rapidly and somewhat independent to weight loss. We hypothesized that in non-obese patients with T2DM, the glycemic control would be achieved as a consequence of gastric bypass surgery.

METHODS

From September 2009, the 172 patients have had laparoscopic single anastomosis gastric bypass (LSAGB) surgery. Among them, 107 patients have been followed up more than 1 year. We analyzed the dataset of these patients. Values related to diabetes were measured before and 1, 2, and 3 years after the surgery.

RESULTS

The mean BMI decreased during the first year after the surgery but plateaued after that. The mean glycosylated hemoglobin level decreased continuously. The mean fasting and postglucose loading plasma glucose level also decreased.

CONCLUSION

After LSAGB surgery in non-obese T2DM patients, the control of T2DM was possible safely and effectively. However, longer follow-up with matched control group is essential.

摘要

背景

减重手术是治疗病态肥胖患者2型糖尿病(T2DM)的有效方法。然而,在亚洲国家,T2DM患者的平均体重指数(BMI)约为25kg/m²。关于接受胃旁路手术患者的各种数据表明,术后T2DM的控制迅速,且在一定程度上与体重减轻无关。我们推测,对于非肥胖的T2DM患者,胃旁路手术可实现血糖控制。

方法

自2009年9月起,172例患者接受了腹腔镜单吻合口胃旁路(LSAGB)手术。其中,107例患者接受了超过1年的随访。我们分析了这些患者的数据集。在手术前以及术后1年、2年和3年测量与糖尿病相关的值。

结果

术后第一年平均BMI下降,但之后趋于平稳。平均糖化血红蛋白水平持续下降。空腹和葡萄糖负荷后血浆葡萄糖平均水平也下降。

结论

非肥胖T2DM患者接受LSAGB手术后,能够安全有效地控制T2DM。然而,与匹配对照组进行更长时间的随访至关重要。

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