Wang Guo-Feng, Yan Yong-Xin, Xu Ning, Yin Dong, Hui Yuan, Zhang Ji-Ping, Han Guan-Jun, Ma Ning, Wu Yan, Xu Jing-Zi, Yang Tao
Department of Endocrinology Medicine, Lianyungang First People's Hospital, Affiliated Hospital of Xuzhou Medical College, Tongguan North Road 182, Lianyungang City, Jiangsu Province, 222000, China,
Obes Surg. 2015 Feb;25(2):199-208. doi: 10.1007/s11695-014-1391-y.
Although a few studies have been reported on predictive factors of postoperative diabetes remission, the conclusions remain inconsistent. This meta-analysis aimed to assess the preoperative clinical factors for type 2 diabetes mellitus (T2DM) remission after bariatric surgery.
The Cochrane Library, PubMed, MEDLINE, Embase, and CINAHL databases were searched. All human studies published in English between 1 January 1992 and 1 September 2013 reporting on the parameters of interest were included.
In total, 15 studies involving 1,753 bariatric surgery patients were selected. Analyses were performed separately for the parameters of interest. T2DM remission was observed to be negatively correlated with age, diabetes duration, insulin use, and HbA1c levels. Baseline body mass index (BMI) and C-peptide levels were positively associated with the remission rate in Asian patients. However, there was no significant association between gender and remission rate.
Patients with younger age, short diabetes duration, better glucose control, and better β cell function were more likely to achieve T2DM remission after bariatric surgery. However, further randomized controlled trials with uniform remission criteria should be conducted to provide more reliable evidence.
尽管已有一些关于术后糖尿病缓解预测因素的研究报道,但结论仍不一致。本荟萃分析旨在评估减肥手术后2型糖尿病(T2DM)缓解的术前临床因素。
检索了Cochrane图书馆、PubMed、MEDLINE、Embase和CINAHL数据库。纳入了1992年1月1日至2013年9月1日期间发表的所有英文人类研究,这些研究报告了相关参数。
共选择了15项涉及1753例减肥手术患者的研究。对相关参数进行了单独分析。观察到T2DM缓解与年龄、糖尿病病程、胰岛素使用和糖化血红蛋白水平呈负相关。基线体重指数(BMI)和C肽水平与亚洲患者的缓解率呈正相关。然而,性别与缓解率之间无显著关联。
年龄较小、糖尿病病程较短、血糖控制较好以及β细胞功能较好的患者在减肥手术后更有可能实现T2DM缓解。然而,应进行更多具有统一缓解标准的随机对照试验,以提供更可靠的证据。