Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
CNR Institute of Clinical Physiology, Pisa, Italy.
Obes Surg. 2020 Jun;30(6):2266-2273. doi: 10.1007/s11695-020-04465-9.
Postprandial hypoglycemia (PPHG) is a well-known complication after bariatric surgery (BS). However, it is not known whether PPHG affects weight loss after BS.
To assess the impact of PPHG on weight loss after BS in subjects without and with type 2 diabetes mellitus (T2D).
Data from 338 subjects who had undergone gastric bypass (RYGB) or sleeve gastrectomy (LSG) and were followed up for at least 2 years were analyzed. At each follow-up visit, the patient's anthropometric and biochemical characteristics were recorded and the Edinburgh Questionnaire was performed to evaluate the presence of PPHG symptoms.
Before surgery: younger age and lower BMI predicted PPHG after BS (p = 0.02 and p = 0.0008, respectively). Also, the baseline OGTT indicated that subjects who developed PPHG had an earlier glucose peak and more often had low glucose levels at 2 h compared with the no-PPHG group (p = 0.03 and p = 0.004, respectively). After surgery: Mild-to-moderate PPHG occurred equally after RYGB and LSG (38% vs 25%, p = ns when accounting for confounders), and in T2D who achieved remission and those who did not (29.5% vs 28.6%, ns). At the 2-year follow-up, occurrence of PPHG was independently associated with smaller weight loss (p = 0.0006).
Mild-to-moderate PPHG is a frequent complication after bariatric surgery and results in smaller weight loss after 2 years. Age, baseline BMI, and an earlier glucose peak during OGTT predict PPHG after bariatric surgery.
减重手术后（BS）后发生的餐后低血糖（PPHG）是一种众所周知的并发症。然而，尚不清楚 PPHG 是否会影响 BS 后的减重效果。
评估 PPHG 对无和有 2 型糖尿病（T2D）的 BS 后减重的影响。
分析了 338 例接受胃旁路术（RYGB）或袖状胃切除术（LSG）并至少随访 2 年的患者的数据。在每次随访时，记录患者的人体测量和生化特征，并进行爱丁堡问卷以评估 PPHG 症状的存在。
手术前：年龄较小和 BMI 较低预测 BS 后会发生 PPHG（分别为 p=0.02 和 p=0.0008）。此外，基线 OGTT 表明，发生 PPHG 的患者葡萄糖峰值更早，并且在 2 小时时更常出现低血糖（分别为 p=0.03 和 p=0.004）。手术后：RYGB 和 LSG 后均会发生轻中度 PPHG（38% vs 25%，当考虑混杂因素时 p=ns），在 T2D 患者中，缓解和未缓解的患者发生率相同（29.5% vs 28.6%，ns）。在 2 年的随访中，PPHG 的发生与体重减轻量较小独立相关（p=0.0006）。
轻中度 PPHG 是 BS 后常见的并发症，会导致 2 年后体重减轻量较小。年龄、基线 BMI 和 OGTT 中更早的葡萄糖峰值可预测 BS 后的 PPHG。
