Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Sci Rep. 2021 Mar 16;11(1):6002. doi: 10.1038/s41598-021-85450-9.
Many bariatric procedures are more effective for improving type-2 diabetes mellitus (T2DM) than conventional pharmacotherapy. The current research evaluated factors linked to complete and partial remission or improvement of T2DM after laparoscopic sleeve gastrectomy (LSG). The current prospective study included all diabetic patients who were submitted LSG between January 2015 and June 2018 and completed a 2-year follow-up period. Patients were assessed at baseline and 2 years after LSG. This work comprised of 226 diabetic cases. Two years after LSG, 86 patients (38.1%) achieved complete remission of DM, and 24 (10.6%) reached partial remission. Only 14 patients (6.2%) showed no change in their diabetic status. On univariate analysis, age ≤ 45 years, duration of diabetes ≤ 5 years, use of a single oral antidiabetic, HbA1c ≤ 6.5%, HOMA-IR ≤ 4.6, C-peptide > 2.72 ng/mL, and BMI ≤ 40 kg/m predicted complete remission. The independent predictors of complete remission were age ≤ 45 years, duration of diabetes ≤ 5 years, use of a single oral antidiabetic, HOMA-IR ≤ 4.6, and C-peptide > 2.72 ng/mL. A combined marker of young age, short duration of DM, and low HOMA-IR predicted complete remission with sensitivity 93% and specificity 82%. Independent predictors of complete remission of T2DM after LSG were younger age, shorter duration, single oral antidiabetic, lower HOMA-IR, and higher C-peptide.
许多减重手术在改善 2 型糖尿病（T2DM）方面比传统药物治疗更有效。本研究评估了腹腔镜袖状胃切除术（LSG）后与 T2DM 完全和部分缓解或改善相关的因素。本前瞻性研究纳入了 2015 年 1 月至 2018 年 6 月间接受 LSG 的所有糖尿病患者，并完成了 2 年的随访。患者在 LSG 前和 2 年后进行评估。本研究共纳入 226 例糖尿病患者。LSG 后 2 年，86 例（38.1%）患者达到 DM 完全缓解，24 例（10.6%）患者达到部分缓解。仅有 14 例（6.2%）患者糖尿病状态无变化。单因素分析显示，年龄≤45 岁、糖尿病病程≤5 年、使用一种口服降糖药、HbA1c≤6.5%、HOMA-IR≤4.6、C 肽>2.72ng/ml 和 BMI≤40kg/m2 预测完全缓解。年龄≤45 岁、糖尿病病程≤5 年、使用一种口服降糖药、HOMA-IR≤4.6 和 C 肽>2.72ng/ml 是完全缓解的独立预测因素。年龄小、糖尿病病程短、HOMA-IR 低的联合标志物预测完全缓解的敏感性为 93%，特异性为 82%。LSG 后 T2DM 完全缓解的独立预测因素是年龄较小、糖尿病病程较短、单一口服降糖药、较低的 HOMA-IR 和较高的 C 肽。
