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代谢手术对 2 型糖尿病的心血管影响。

Cardiovascular Effects of Metabolic Surgery on Type 2 Diabetes.

机构信息

Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Psychiatric Department, General Hospital of Athens G. Gennimatas, Athens, Greece.

出版信息

Curr Cardiol Rev. 2020;16(4):275-284. doi: 10.2174/1573403X16666200220120226.

Abstract

INTRODUCTION

Cardiovascular, together with renal disease, claims a significant proportion of morbidity and mortality in association with type 2 diabetes mellitus (T2DM) and obesity. To improve the long-term renal and cardiovascular outcome, there is the incorporation of bariatric surgery (BS), which seems to be a pivotal intervention. Areas Explored: Cohort studies and randomized controlled trial (RCT) research of BS among patients with T2DM, were conducted by screening, and then information on renal effects and the cardiovascular outcome was gathered. Metabolic surgery (MS) and BS reduce both mortality and the risk of cardiovascular disorder, chronic kidney diseases and albuminuria. MS refers to a surgical approach, the primary intent of which is the control of metabolic alterations/hyperglycemia in contrast to BS which is a mere weight-reduction therapy. Patients suffering from poor glycaemic control and other macro and micro-vascular diseases will benefit from a surgical approach. The approach implicates hypertension glomerular remission, gut microbiota shift, reduced renal inflammation and fewer instances of chronic cardiac remodelling.

CONCLUSION

MS is beneficial where the main aim is to attain significant and long-lasting weight loss results. The RCTs have depicted the superiority which surgical mechanisms hold over medically- based therapy, for enhancing glycaemic control, and achieving remission of diabetes. This type of surgery improves life quality, reduces incidences of other obesity and diabetes related diseases like microvascular disases, sleep apnea, fatal disorder, and fatty liver disease.

摘要

简介

心血管疾病与肾脏疾病一起,在 2 型糖尿病(T2DM)和肥胖症患者中导致了相当大比例的发病率和死亡率。为了改善长期的肾脏和心血管预后,需要进行减重手术(BS),这似乎是一种关键的干预措施。探讨领域:通过筛选,对 T2DM 患者进行 BS 的队列研究和随机对照试验(RCT)研究,收集有关肾脏效果和心血管结局的信息。代谢手术(MS)和 BS 降低了死亡率和心血管疾病、慢性肾脏病和白蛋白尿的风险。MS 是一种手术方法,其主要目的是控制代谢改变/高血糖,而 BS 只是一种减肥疗法。血糖控制不佳和其他大血管和微血管疾病的患者将受益于手术方法。这种方法涉及高血压肾小球缓解、肠道微生物群转移、减少肾脏炎症和减少慢性心脏重塑的发生。

结论

MS 有利于达到显著和持久的减肥效果的情况。RCT 表明,手术机制在改善血糖控制和糖尿病缓解方面优于基于医学的治疗。这种手术提高了生活质量,降低了其他肥胖症和糖尿病相关疾病的发病率,如微血管疾病、睡眠呼吸暂停、致命疾病和脂肪肝疾病。

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