Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Obes Surg. 2020 Jul;30(7):2631-2636. doi: 10.1007/s11695-020-04534-z.
Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbidly obese patients to improve type 2 diabetes mellitus (T2DM). Recently, T2DM patients with a lower body mass index (BMI) have been receiving more attention, and these patients could benefit from RYGB.
Fifty-two patients with T2DM underwent RYGB between October 2008 and December 2012 in our hospital. Weight, BMI, oral glucose tolerance test (OGTT), insulin release test (IRT), C-peptide release test (CRT), glycosylated hemoglobin (HbA1c), and lipid metabolic parameters were measured at baseline and at 3 and 6 months and 1, 2, 3, 4, 5, and 6 years after surgery.
The mean age of the 52 patients was 46.8 ± 9.5 years, and 57.7% were male. The mean duration of T2DM was 6.5 ± 4.6 years. Compared with the baseline values, weight and BMI were significantly decreased at several time points after surgery. HbA1c decreased from 8.2 ± 1.7% at baseline to 6.5 ± 1.4% at 3 months, 6.5 ± 1.4% at 6 months, 7.2 ± 1.3% at 4 years, and 7.5 ± 1.2% at 6 years. OGTT, OGTT-IRT, and OGTT-CRT improved after surgery. There was a decrease in triglycerides (TGs), total cholesterol (TC), and low-density lipoprotein (LDL) and an increase in high-density lipoprotein (HDL). At 6 years after surgery, 16.7% of patients achieved complete remission of T2DM, and 66.7% achieved improvement in T2DM.
RYGB may be a safe and effective treatment for T2DM patients with a BMI < 32.5 kg/m in China. However, a long-term study without loss to follow-up is necessary for better evaluation.
Roux-en-Y 胃旁路术（RYGB）是治疗病态肥胖患者改善 2 型糖尿病（T2DM）的有效方法。最近，体重指数（BMI）较低的 T2DM 患者受到了更多关注，这些患者可能从 RYGB 中受益。
2008 年 10 月至 2012 年 12 月期间，我院对 52 例 T2DM 患者行 RYGB 治疗。分别于基线及术后 3、6 个月和 1、2、3、4、5、6 年测量体重、BMI、口服葡萄糖耐量试验（OGTT）、胰岛素释放试验（IRT）、C 肽释放试验（CRT）、糖化血红蛋白（HbA1c）和血脂代谢参数。
52 例患者的平均年龄为 46.8±9.5 岁，57.7%为男性。T2DM 的平均病程为 6.5±4.6 年。与基线相比，术后多个时间点体重和 BMI 明显下降。HbA1c 从基线时的 8.2±1.7%降至术后 3 个月时的 6.5±1.4%、术后 6 个月时的 6.5±1.4%、术后 4 年时的 7.2±1.3%、术后 6 年时的 7.5±1.2%。OGTT、OGTT-IRT 和 OGTT-CRT 术后均改善。甘油三酯（TGs）、总胆固醇（TC）、低密度脂蛋白（LDL）降低，高密度脂蛋白（HDL）升高。术后 6 年时，16.7%的患者 T2DM 完全缓解，66.7%的患者 T2DM 改善。
RYGB 可能是中国 BMI<32.5kg/m2 的 T2DM 患者的一种安全有效的治疗方法。但需要进行长期、无失访的研究以更好地评估。
