中国肥胖糖尿病患者接受Roux-en-Y胃旁路手术后心血管风险降低

Decreased Cardiovascular Risk after Roux-en-Y Gastric Bypass Surgery in Chinese Diabetic Patients with Obesity.

作者信息

Zhao Xue, Duan Wenyan, Sun Chenglin, Li Zhuo, Liu Yujia, Xiao Xianchao, Wang Gang, Gang Xiaokun, Wang Guixia

机构信息

Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin Province 130021, China.

Jilin Province People's Hospital, Changchun, Jilin Province 130021, China.

出版信息

J Diabetes Res. 2017;2017:5612049. doi: 10.1155/2017/5612049. Epub 2017 Jul 4.

DOI:10.1155/2017/5612049

PMID:28744472

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5514332/

Abstract

BACKGROUND

The influence of bariatric surgery on cardiovascular risks in Chinese diabetic patients remains unclear. Here, we aimed to explore the impact of Roux-en-Y gastric bypass surgery (RYGB) on cardiovascular risks in Chinese diabetic patients with obesity.

METHODS

Twenty Chinese patients with T2DM and obesity undergoing RYGB surgery were included in this study. Cardiovascular risk factors were measured before and 18 months after surgery. A 10-year cardiovascular risk was calculated by the UKPDS risk engine. Linear regression analysis was performed on CHD risk, stroke risk, and baseline metabolic parameters.

RESULTS

The complete remission rate of diabetes was 90% after RYGB surgery, with significant improvements in blood pressure, BMI, glucose, and lipid metabolism ( < 0.05). The 10-year cardiovascular risk of coronary heart disease reduced from 13.05% to 3.81% ( = 0.001) and the 10-year risk of stroke reduced from 19.66% to 14.22% ( = 0.002). In subgroup analysis, Chinese diabetic patients who were women, <45 years old, with BMI < 35 kg/m, and DM duration > 5 years, using noninsulin therapy presented more obvious improvements in the 10-year cardiovascular risk after RYGB surgery. WHR, age, LDL-C, and HbA1c were the most important factors influencing CHD or stroke risk after RYGB surgery ( < 0.01).

CONCLUSION

RYGB surgery is an effective treatment to reduce cardiovascular risk in Chinese diabetic patients with obesity.

摘要

背景

减重手术对中国糖尿病患者心血管风险的影响尚不清楚。在此，我们旨在探讨 Roux-en-Y 胃旁路手术（RYGB）对中国肥胖糖尿病患者心血管风险的影响。

方法

本研究纳入了 20 例接受 RYGB 手术的中国 2 型糖尿病肥胖患者。在手术前和术后 18 个月测量心血管危险因素。通过 UKPDS 风险引擎计算 10 年心血管风险。对冠心病风险、中风风险和基线代谢参数进行线性回归分析。

结果

RYGB 手术后糖尿病的完全缓解率为 90%，血压、体重指数、血糖和脂质代谢有显著改善（<0.05）。冠心病的 10 年心血管风险从 13.05%降至 3.81%（=0.001），中风的 10 年风险从 19.66%降至 14.22%（=0.002）。在亚组分析中，女性、<45 岁、体重指数<35 kg/m²且糖尿病病程>5 年、使用非胰岛素治疗的中国糖尿病患者在 RYGB 手术后 10 年心血管风险有更明显改善。腰臀比、年龄、低密度脂蛋白胆固醇和糖化血红蛋白是影响 RYGB 手术后冠心病或中风风险的最重要因素（<0.01）。