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日本肥胖患者胃旁路术后 CT 评估的密度、腹部脂肪量与糖代谢的关系。

Relationships between computed tomography-assessed density, abdominal fat volume, and glucose metabolism after sleeve gastrectomy in Japanese patients with obesity.

机构信息

Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan.

Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Oita 879-5593, Japan.

出版信息

Endocr J. 2019 Jul 28;66(7):605-613. doi: 10.1507/endocrj.EJ18-0543. Epub 2019 Apr 23.

Abstract

In this study, we investigated the relationships between body weight (BW), computed tomography (CT)-assessed abdominal adipose tissue, and the glycemic metabolic profile in obese Japanese patients following laparoscopic sleeve gastrectomy (LSG). This study analyzed adipose tissue compartments using CT methods before and 1 year after LSG. Thirty obese patients were studied, and variables measured included visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), density of VAT (VAT-D), and density of SAT (SAT-D). We also examined the parameters in patients according to whether they had type-2 diabetes (T2DM). LSG induced significant losses in BW, SAT, and VAT after LSG. Additionally, SAT-D and VAT-D both increased and fasting plasma glucose (FPG) and HbA1c, but not C-peptide, decreased after surgery. ΔSAT and ΔVAT were positively related, and ΔSAT-D and ΔVAT-D were negatively related to ΔBW and/or FPG. Furthermore, a multivariate regression model showed that total BW loss (TBWL) was closely related to ΔSAT (β = 0.84; p < 0.001) and ΔVAT-D (β = -0.45; p < 0.05) and improvement of FPG was related to ΔVAT (β = 0.61; p < 0.05) after LSG. Finally, ΔFPG was correlated with ΔVAT in 16 T2DM patients (r = 0.58; p < 0.05) but not in non-T2DM patients. TBWL was related to ΔSAT and ΔVAT-D, and improvement of FPG was related to ΔVAT in obese Japanese patients after LSG.

摘要

在这项研究中,我们调查了肥胖日本患者腹腔镜袖状胃切除术(LSG)后体重(BW)、计算机断层扫描(CT)评估的腹部脂肪组织与血糖代谢特征之间的关系。本研究使用 CT 方法分析了 LSG 前后的脂肪组织隔室。研究了 30 名肥胖患者,测量的变量包括内脏脂肪组织(VAT)、皮下脂肪组织(SAT)、VAT 密度(VAT-D)和 SAT 密度(SAT-D)。我们还根据患者是否患有 2 型糖尿病(T2DM)检查了参数。LSG 诱导 BW、SAT 和 VAT 在 LSG 后显著减少。此外,SAT-D 和 VAT-D 均增加,空腹血糖(FPG)和 HbA1c 降低,但 C 肽不降低。手术后 ΔSAT 和 ΔVAT 呈正相关,ΔSAT-D 和 ΔVAT-D 与 ΔBW 和/或 FPG 呈负相关。此外,多元回归模型显示,总 BW 损失(TBWL)与 ΔSAT(β=0.84;p<0.001)和 ΔVAT-D(β=-0.45;p<0.05)密切相关,FPG 的改善与 ΔVAT(β=0.61;p<0.05)有关LSG 后。最后,16 例 T2DM 患者中 ΔFPG 与 ΔVAT 相关(r=0.58;p<0.05),而非 T2DM 患者中则不相关。TBWL 与 ΔSAT 和 ΔVAT-D 相关,FPG 的改善与 LSG 后肥胖日本患者的 ΔVAT 相关。

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