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四种减肥手术治疗肥胖2型糖尿病患者有效性的比较:一项回顾性研究

Comparison of the effectiveness of four bariatric surgery procedures in obese patients with type 2 diabetes: a retrospective study.

作者信息

Pham Sylvie, Gancel Antoine, Scotte Michel, Houivet Estelle, Huet Emmanuel, Lefebvre Hervé, Kuhn Jean-Marc, Prevost Gaetan

机构信息

Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Rouen, 76031 Rouen, France.

Department of Digestive Surgery, University Hospital of Rouen, 76031 Rouen, France.

出版信息

J Obes. 2014;2014:638203. doi: 10.1155/2014/638203. Epub 2014 May 22.

Abstract

AIM

The aim of the present retrospective study was to evaluate the efficacy of four bariatric surgical procedures to induce diabetes remission and lower cardiovascular risk factors in diabetic obese patients. Moreover, the influence of surgery on weight evolution in the diabetic population was compared with that observed in a nondiabetic matched population.

METHODS

Among 970 patients who were operated on in our center since 2001, 81 patients were identified as type 2 diabetes. Laparoscopic adjustable gastric banding (GB), intervention type Mason (MA), gastric bypass (RYGB), and sleeve gastrectomy (SG) were performed, respectively, in 25%, 17%, 28%, and 30% of this diabetic population.

RESULTS

The resolution rate of diabetes one year after surgery was significantly higher after SG than GB (62.5% versus 20%, P < 0.01), but not significantly different between SG and RYGB. In terms of LDL-cholesterol reduction, RYGB was equivalent to SG and superior to CGMA or GB. Considering the other cardiovascular risk factors, there was no significant difference according to surgical procedures. The weight loss was not statistically different between diabetic and nondiabetic matched patients regardless of the surgical procedures used.

CONCLUSION

Our data confirm that the efficacy of surgery to treat diabetes is variable among the diverse procedures and SG might be an interesting option in this context.

摘要

目的

本回顾性研究旨在评估四种减肥手术对糖尿病肥胖患者诱导糖尿病缓解及降低心血管危险因素的疗效。此外,将糖尿病患者手术对体重变化的影响与非糖尿病匹配人群中观察到的情况进行比较。

方法

在2001年以来于本中心接受手术的970例患者中,81例被确定为2型糖尿病患者。腹腔镜可调节胃束带术(GB)、Mason术式干预(MA)、胃旁路术(RYGB)和袖状胃切除术(SG)分别在该糖尿病患者人群的25%、17%、28%和30%中实施。

结果

术后一年糖尿病缓解率SG组显著高于GB组(62.5%对20%,P<0.01),但SG组与RYGB组之间无显著差异。在降低低密度脂蛋白胆固醇方面,RYGB与SG相当,且优于CGMA或GB。考虑其他心血管危险因素,不同手术方式之间无显著差异。无论采用何种手术方式,糖尿病患者与非糖尿病匹配患者之间的体重减轻在统计学上无差异。

结论

我们的数据证实,不同手术方式治疗糖尿病的疗效存在差异,在此背景下SG可能是一个有吸引力的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6ee/4055665/c927a278abcb/JOBE2014-638203.001.jpg

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