Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Surg Obes Relat Dis. 2019 Feb;15(2):168-172. doi: 10.1016/j.soard.2018.11.023. Epub 2018 Nov 24.
Obesity is a major independent risk factor for developing type 2 diabetes (T2D).
Our goal in this study was to analyze the impact of laparoscopic sleeve gastrectomy in the risk reduction of developing T2D in middle-aged, severely obese nondiabetes patients.
University Hospital, United States.
We retrospectively reviewed our prospectively collected database from 2010 to 2016. All severely obese patients between 45 and 64 years of age without diabetes at baseline that underwent sleeve gastrectomy were included in our study. The T2D risk score for predicting the incidence of diabetes was measured preoperatively and at 12 months postoperatively and was based on the Framingham Offspring Study that calculates an 8-year risk of developing T2D.
Of the 1330 patients included in this study, 6.5% (n = 86) met the criteria for the T2D risk score calculation. The population was predominantly composed of females (68.9%; n = 59) with a mean age of 52.8 ± 5.3 years. Preoperative body mass index was 43.1 ± 6.9 kg/m with a percentage of estimated body mass index loss and percentages of total weight loss were 72.2 ± 26.3% and 26.39 ± 18.15%, respectively, with fasting plasma glucose of 103.3 ± 14.9 mg/dL. The preoperative risk for T2D was 13.9 ± 11.6%, with an absolute risk reduction 12 months after surgery of 10.3%, corresponding to a 74.2% relative risk reduction. When comparing between sexes, risk reduction in females was slightly better than in males; however, this was not statistically significant. At 12-month follow-up, all measured variables were significantly improved, except for diastolic blood pressure.
Laparoscopic sleeve gastrectomy significantly decreases the risk of developing T2D in middle-aged severely obese patients. Prospective studies are needed to further understand these findings.
肥胖是 2 型糖尿病（T2D）的一个主要独立危险因素。
本研究旨在分析腹腔镜袖状胃切除术对中年肥胖非糖尿病患者 T2D 发病风险降低的影响。
美国大学医院。
我们回顾性分析了 2010 年至 2016 年前瞻性收集的数据库。所有在基线时年龄在 45 至 64 岁之间且无糖尿病的重度肥胖患者均纳入本研究。T2D 风险评分用于预测糖尿病的发生率，在术前和术后 12 个月进行测量，该评分基于弗雷明汉后代研究，该研究计算了 8 年内发生 T2D 的风险。
在这项研究中，共有 1330 名患者符合 T2D 风险评分计算标准，占 6.5%（n=86）。该人群主要由女性（68.9%；n=59）组成，平均年龄为 52.8±5.3 岁。术前体重指数为 43.1±6.9kg/m，估计体重指数丢失率和总体重减轻率分别为 72.2%±26.3%和 26.39%±18.15%，空腹血糖为 103.3±14.9mg/dL。术前 T2D 的风险为 13.9%±11.6%，术后 12 个月风险降低 10.3%，相应的相对风险降低 74.2%。在比较性别时，女性的风险降低略好于男性，但无统计学意义。在 12 个月的随访中，除舒张压外，所有测量的变量均显著改善。
腹腔镜袖状胃切除术可显著降低中年重度肥胖患者发生 T2D 的风险。需要进一步的前瞻性研究来深入了解这些发现。
