低体重指数的中国2型糖尿病患者能从腹腔镜Roux-en-Y胃旁路手术中获益吗？
Can low BMI Chinese patients with type 2 diabetes benefit from laparoscopic Roux-en-Y gastric bypass surgery?
作者信息
Wang Guohui, Zhu Liyong, Li Weizheng, Yang Xiangwu, Li Pengzhou, Zhu Shaihong
机构信息
Centre of Experimental Medicine, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
出版信息
Surg Obes Relat Dis. 2016 Dec;12(10):1890-1895. doi: 10.1016/j.soard.2016.06.005. Epub 2016 Jul 12.
BACKGROUND
The efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes mellitus (T2D) is closely associated with the preoperative body mass index (BMI) of the patient. There is a lack of long-term and large sampling evidence on the efficacy of LRYGB in T2D patients with low BMI in China.
OBJECTIVES
This retrospective study aimed to evaluate the efficacy of surgical treatment in a Chinese population with T2D (especially patients with BMI<27.5 kg/m).
SETTING
University-affiliated hospital, China METHODS: Seventy-eight patients with T2D were included in the study and evaluated before and after LRYGB surgery. No patients were lost to follow-up at any time points.
RESULTS
Thirty-eight T2D patients with BMI≥27.5 kg/m in group 1 (high BMI group) had significant improvements in waist circumference, blood glucose levels, homeostasis model assessment-insulin resistance index, and C-peptide levels after LRYGB (P<.05). Forty T2D patients with BMI<27.5 kg/m in group 2 (low BMI group, including 19 T2D patients with BMI<25 kg/m) had significant improvements in waist circumference and waist-to-hip ratio after LRYGB (P< .05).
CONCLUSIONS
LRYGB surgery may be beneficial in T2D patients with BMI<27.5 kg/m in China.
背景
腹腔镜Roux-en-Y胃旁路术（LRYGB）治疗2型糖尿病（T2D）的疗效与患者术前体重指数（BMI）密切相关。在中国，关于LRYGB治疗低BMI的T2D患者疗效的长期大样本证据不足。
目的
这项回顾性研究旨在评估手术治疗在中国T2D人群（尤其是BMI<27.5 kg/m的患者）中的疗效。
地点
中国大学附属医院
方法
本研究纳入78例T2D患者，并在LRYGB手术前后进行评估。在任何时间点均无患者失访。
结果
第1组（高BMI组）38例BMI≥27.5 kg/m的T2D患者在LRYGB术后腰围、血糖水平、稳态模型评估胰岛素抵抗指数及C肽水平均有显著改善（P<0.05）。第2组（低BMI组，包括19例BMI<25 kg/m的T2D患者）40例BMI<27.5 kg/m的T2D患者在LRYGB术后腰围及腰臀比有显著改善（P<0.05）。
结论
在中国，LRYGB手术可能对BMI<27.5 kg/m的T2D患者有益。
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