Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, Jiangsu, People's Republic of China.
Obes Surg. 2020 Jan;30(1):18-22. doi: 10.1007/s11695-019-04139-1.
Sleeve gastrectomy (SG) has become the most popular bariatric procedure. Although bariatric surgery is recommended for type 2 diabetes mellitus (T2DM) in Asian patients with BMI 27.5-32.4 kg/m, reported evidences, especially following SG, are still lacking.
Patients' data from June 2016 to June 2018 that underwent SG as primary surgery at our setting were analyzed. Patients with T2DM, without insulin use and BMI 27.5-30 kg/m, were our main criteria. Preoperative and postoperative parameters were as such: age, BMI, T2DM duration, anti-diabetic medications, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), insulin, C-peptide, and homeostatic model assessment-insulin resistance (HOMA-IR). Follow-up duration was at 1, 3, 6, and 12 months.
Eighteen patients (7 male and 11 female) were presented for this study. The mean age and diabetes duration were 46.3 ± 11.9 years and 31.8 ± 26.5 months, respectively. The mean preoperative vs postoperative 12-month assessment was as such: BMI 29.3 ± 0.9 vs 23.9 ± 0.9 kg/m, FPG 8.4 ± 3.1 vs 5.6 ± 0.7 mmol/L, HbA1c 8.3 ± 1.8 vs 5.9 ± 0.7%, insulin 103.9 ± 47.4 vs 53.9 ± 13.1 pmol/L, C-peptide 1.90 ± 1.22 vs 1.08 ± 0.44 ng/ml, and HOMA-IR 5.5 ± 4.0 vs 1.9 ± 0.6, all reached statistical significance (p value < 0.05).
In short-term, and also under strict selection criteria, SG can result in both improvement and remission of T2DM in patients with BMI 27.5-30 kg/m. Larger sample size and longer follow-up duration will be needed in the future.
袖状胃切除术（SG）已成为最受欢迎的减肥手术。尽管亚洲患者 BMI 为 27.5-32.4kg/m 时，推荐进行减重手术以治疗 2 型糖尿病（T2DM），但仍缺乏相关报告证据，尤其是在 SG 之后。
分析了 2016 年 6 月至 2018 年 6 月期间在我院行 SG 作为初次手术的患者数据。我们的主要标准是 T2DM 患者、未使用胰岛素且 BMI 为 27.5-30kg/m。分析术前和术后的以下参数：年龄、BMI、T2DM 持续时间、降糖药物、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、胰岛素、C 肽和稳态模型评估-胰岛素抵抗（HOMA-IR）。随访时间为 1、3、6 和 12 个月。
本研究共纳入 18 例患者（7 例男性和 11 例女性）。平均年龄和糖尿病病程分别为 46.3±11.9 岁和 31.8±26.5 个月。与术后 12 个月的平均评估相比：BMI 从 29.3±0.9kg/m 降至 23.9±0.9kg/m、FPG 从 8.4±3.1mmol/L 降至 5.6±0.7mmol/L、HbA1c 从 8.3±1.8%降至 5.9±0.7%、胰岛素从 103.9±47.4pmol/L 降至 53.9±13.1pmol/L、C 肽从 1.90±1.22ng/ml 降至 1.08±0.44ng/ml、HOMA-IR 从 5.5±4.0 降至 1.9±0.6，均具有统计学意义（p 值均<0.05）。
在短期内，并且在严格的选择标准下，SG 可以使 BMI 为 27.5-30kg/m 的 T2DM 患者的 T2DM 得到改善和缓解。未来需要更大的样本量和更长的随访时间。
