非病态肥胖的胃癌合并糖尿病患者胃切除术后的血糖变化

Glycemic changes after gastrectomy in non-morbidly obese patients with gastric cancer and diabetes.

作者信息

Shen Zhiyong, Yu Jiang, Lei Shangtong, Mou Tingyu, Hu Yanfeng, Liu Hao, Li Guoxin

出版信息

Hepatogastroenterology. 2015 Jan-Feb;62(137):245-50.

PMID:25911904

Abstract

BACKGROUND/AIMS: To evaluate the glycemic changes after gastrectomy in non-morbidly obese patients with gastric cancer (GC) and type 2 diabetes mellitus (T2DM).

METHODOLOGY

Between December 2011 and June 2014, we included 46 patients with gastric cancer and T2DM of a body mass index (BMI) < 30 kg/m2, who underwent gastrectomy in our center. The comparisons of FPGs in specific periods were performed according to age, extent of gastrectomy, reconstruction type, preoperative triglyceride (TG) level and so on.

RESULTS

The non-morbidly obese patients experienced an improvement of glycemic control. T2DM resolution happened 3 weeks after surgery. FPG decreased significantly after postoperative day 21 compared to preoperative FPG. 32 patients experienced DM improvement after postoperative day 21. The age and relatively lower preoperative TG patients, who underwent total gastrectomy (P<0.001) or duodenal bypass reconstruction (Billroth II, Roux-en-Y gastrojejunostomy, or Roux-en-Y esophagojejunostomy, P=0.009) appeared to have a better glycemic control.

CONCLUSIONS

Our finding observed through this simulation model suggested that non-morbidly obese patients may also benefit from metabolic surgery for glycemic control, associated with age, extent of gastrectomy, reconstruction type, and preoperative triglyceride level.

摘要

背景/目的：评估非病态肥胖的胃癌（GC）合并2型糖尿病（T2DM）患者胃切除术后的血糖变化。

方法

2011年12月至2014年6月，我们纳入了46例体重指数（BMI）<30kg/m²的胃癌合并T2DM患者，这些患者在我们中心接受了胃切除术。根据年龄、胃切除范围、重建类型、术前甘油三酯（TG）水平等对特定时期的空腹血糖（FPG）进行比较。

结果

非病态肥胖患者的血糖控制得到改善。术后3周出现T2DM缓解。术后第21天的FPG较术前FPG显著降低。32例患者在术后第21天血糖得到改善。年龄较小且术前TG水平相对较低、接受全胃切除术（P<0.001）或十二指肠旁路重建术（毕Ⅱ式、Roux-en-Y胃空肠吻合术或Roux-en-Y食管空肠吻合术，P=0.009）的患者血糖控制似乎更好。