Sheng Binwu, Truong Khoa, Spitler Hugh, Zhang Lu, Tong Xuetao, Chen Liwei
Department of Surgery, the First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xian Shi, China.
Department of Public Health Sciences, Clemson University, 511 Edwards Hall, 201 Epsilon Zeta Dr., Clemson, SC, 29634, USA.
Obes Surg. 2017 Oct;27(10):2724-2732. doi: 10.1007/s11695-017-2866-4.
This systematic review aimed to evaluate the long-term (≥ 5 years) outcomes of bariatric surgery on diabetes remission, microvascular and macrovascular events, and mortality among type 2 diabetes (T2D) patients. Ten articles (one randomized controlled trial and nine cohorts) met the inclusion criteria and were included in this review. Pooled estimates of nine cohort studies showed that surgery significantly increased the diabetes remission (relative risk (RR) = 5.90; 95% CI 3.75-9.28), reduced the microvascular (RR = 0.37; 95% CI = 0.30-0.46) and macrovascular events (RR = 0.52; 95% CI 0.44-0.61), and mortality (RR = 0.21; 95% CI 0.20-0.21) as compared to non-surgical treatment. Available evidence suggests better remission and lower risks of microvascular and macrovascular disease and mortality in the surgery group as compared to non-surgical treatment group in T2D patients after at least 5 years of follow-up.
本系统评价旨在评估减重手术对2型糖尿病（T2D）患者糖尿病缓解、微血管和大血管事件以及死亡率的长期（≥5年）结局。十篇文章（一篇随机对照试验和九篇队列研究）符合纳入标准并被纳入本评价。九项队列研究的汇总估计显示，与非手术治疗相比，手术显著提高了糖尿病缓解率（相对风险（RR）=5.90；95%置信区间3.75-9.28），降低了微血管（RR=0.37；95%置信区间=0.30-0.46）和大血管事件（RR=0.52；95%置信区间0.44-0.61）以及死亡率（RR=0.21；95%置信区间0.20-0.21）。现有证据表明，在对T2D患者进行至少5年的随访后，与非手术治疗组相比，手术组的缓解情况更好，微血管和大血管疾病风险以及死亡率更低。
