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减重手术与 2 型糖尿病缓解率:一项比较退伍军人和受益人的回顾性队列研究。

Bariatric Surgery and Type 2 Diabetes Remission Rates: a Retrospective Cohort Study Comparing Military Veterans and Beneficiaries.

机构信息

US Military Dietetic Internship Consortium, U.S. Army Medical Center of Excellence, Fort Sam Houston, San Antonio, TX, 78234, USA.

出版信息

Obes Surg. 2021 Apr;31(4):1618-1624. doi: 10.1007/s11695-020-05169-w. Epub 2021 Jan 29.

Abstract

PURPOSE

The disease burden of type 2 diabetes (T2D) costs the military healthcare system an estimated $1.66 billion annually. Thirty-four percent of veterans and 28% of military beneficiaries are obese, a common feature of T2D. Bariatric surgery is a viable treatment for T2D, whether if long-term remission of T2D post-bariatric surgery occurs remains unknown. The purpose of this study was to assess differences between outcomes of veterans and military beneficiaries following bariatric surgery.

MATERIALS AND METHODS

A retrospective cohort study assessed retirees and beneficiaries diagnosed with T2D who had bariatric surgery between 2005 and 2015. Outcomes included T2D remission and vitamin and mineral deficiencies each year for 5 years post-op, analyzed via ANOVA.

RESULTS

Ninety-one patients, 46 beneficiaries and 45 retirees, were included with a mean age of 51 and 57, respectively. No significant differences between T2D remission and vitamin/mineral deficiencies 5 years post-op were found between groups. Patients with uncontrolled diabetes before surgery were less likely to achieve T2D remission for all 5 years post-op, regardless of military affiliation (p < .05).

CONCLUSION

Veterans do not have better rates of T2D remission or weight loss following bariatric surgery than other populations. Control of T2D pre-surgery is a potential clinical indicator of T2D remission success following bariatric surgery.

摘要

目的

2 型糖尿病(T2D)给军队医疗保健系统带来的疾病负担估计每年达 16.6 亿美元。34%的退伍军人和 28%的军队受益人体重超标,这是 T2D 的一个常见特征。减重手术是 T2D 的一种可行治疗方法,但减重手术后 T2D 是否长期缓解尚不清楚。本研究旨在评估退伍军人和军队受益人体重减轻手术后结局的差异。

材料和方法

一项回顾性队列研究评估了 2005 年至 2015 年间接受过减重手术的被诊断患有 T2D 的退休人员和受益人的结局。结果包括 T2D 缓解和术后 5 年内每年的维生素和矿物质缺乏,通过 ANOVA 进行分析。

结果

91 名患者,46 名受益人和 45 名退休人员,平均年龄分别为 51 岁和 57 岁。两组患者术后 5 年内 T2D 缓解和维生素/矿物质缺乏之间没有显著差异。手术前糖尿病控制不佳的患者,无论是否有军队背景,术后所有 5 年 T2D 缓解的可能性均较低(p<0.05)。

结论

退伍军人在减重手术后 T2D 缓解或体重减轻的比例并不高于其他人群。手术前 T2D 的控制可能是减重手术后 T2D 缓解成功的潜在临床指标。

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