Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
Department of Endocrinology, Shanghai Jiao Tong University affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
Obes Surg. 2020 Jul;30(7):2588-2597. doi: 10.1007/s11695-020-04520-5.
RYGB was considered as an effective treatment for obese patients with T2D. However, 5-year outcomes including T2D remission after surgery have not been adequately studied in Chinese patients.
Our aim is to evaluate metabolic outcomes of RYGB in 5-year follow-up.
We retrospectively divided 59 Chinese patients into two groups, namely BMI groups (group A: BMI < 28 kg/m; group B: BMI ≥ 28 kg/m) and A1C groups (group C: A1C < 7%; group D: A1C ≥ 7%). Their medical records were collected and cardiovascular risk and medications were evaluated in 5 years after RYGB.
Thirty patients were female (30/59, 50.85%). RYGB was performed laparoscopically without mortality or major complications. The mean BMI in 59 patients decreased from 30.89 ± 3.12 to 25.04 ± 3.48 in the fifth year. No one was lost to follow-up in 5 years. There were significant reductions in BMI, A1C, and oral medication or insulin in all groups. Diabetes remission rates in the first, third, and fifth years postoperation were 77.97, 61.02, and 49.15%. T2D relapse and requirement for antihypertensive agents increased in the third and fifth years. Larger quantity of subcutaneous fat area (SFA) and shorter duration of T2D preoperation were more likely to achieve remission of T2D postoperation.
This study has confirmed that RYGB is an effective treatment for obese Chinese patients with T2D, resulting in diabetes remission, metabolic disorder control, and cardiovascular risk reduction.
RYGB 被认为是治疗 T2D 肥胖患者的有效方法。然而，在中国患者中，尚未充分研究术后 5 年的 T2D 缓解情况。
本研究旨在评估 RYGB 在 5 年随访期间的代谢结果。
我们回顾性地将 59 名中国患者分为两组，即 BMI 组（A 组：BMI<28 kg/m；B 组：BMI≥28 kg/m）和 A1C 组（C 组：A1C<7%；D 组：A1C≥7%）。收集他们的病历，并在 RYGB 后 5 年内评估心血管风险和药物治疗情况。
30 名患者为女性（30/59，50.85%）。RYGB 均在腹腔镜下进行，无死亡或重大并发症。59 例患者的平均 BMI 在第 5 年从 30.89±3.12 降至 25.04±3.48。5 年内无患者失访。所有组的 BMI、A1C 和口服药物或胰岛素均显著降低。术后第 1、3 和 5 年的糖尿病缓解率分别为 77.97%、61.02%和 49.15%。第 3 和第 5 年 T2D 复发和需要抗高血压药物的比例增加。术前皮下脂肪面积（SFA）越大、T2D 持续时间越短，术后越有可能实现 T2D 的缓解。
本研究证实 RYGB 是治疗中国肥胖 T2D 患者的有效方法，可实现糖尿病缓解、代谢紊乱控制和心血管风险降低。
