迪亚雷姆评分系统在预测卡西姆地区减重手术后2型糖尿病缓解情况中的敏感性

Sensitivity of DiaRem Scoring System in Predicting Type Two Diabetes Mellitus Resolution After Bariatric Surgery in Qassim Region.

作者信息

Assakran Bandar Saad, Alqunai Mansur S, Alromaih Abdullah Homood, Almutairi Laila M, Alharbi Fai M, Almaghyuli Leen M

机构信息

Department of Surgery, King Fahad Specialist Hospital, Buraydah, SAU.

Department of Surgery, College of Medicine, Jouf University, Sakaka, SAU.

出版信息

Cureus. 2021 Nov 30;13(11):e20064. doi: 10.7759/cureus.20064. eCollection 2021 Nov.

DOI:10.7759/cureus.20064

PMID:34873559

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8633883/

Abstract

INTRODUCTION

Type two diabetes mellitus (T2DM) remission has been observed as an additional benefit of bariatric surgery for morbidly obese diabetic patients. There are many scoring systems for identifying factors that predict diabetes remission; however, there is as yet no universally applicable scoring system.

AIM

This study aims to test the sensitivity of the DiaRem scoring system for predicting the resolution of T2DM in morbidly obese patients who underwent bariatric surgery at King Fahad Specialist Hospital in Buraydah, Saudi Arabia.

METHODS

This was a non-randomized controlled trial conducted at King Fahd Specialist Hospital in Buraydah, Saudi Arabia. Visiting patients at first screening were enrolled based on eligibility criteria. Data were collected according to the given parameters such as gender, age, body mass index (BMI), duration of diabetes mellitus (DM), medications (insulin, oral antihyperglycemic agents, number of tablets if used, or no medications use), presence of comorbidities, such as hypertension and dyslipidemia, HbA1c level (before surgery and at third, sixth, and 12th months after surgery), and fasting blood glucose (FBG) level (before and after surgery).

RESULTS

A total of 96 diabetic patients were enrolled (35 males vs 61 females) with a mean age of 46.5 years. Laparoscopic sleeve gastrectomy was the most commonly performed surgery. The most common associated comorbidities were hypertension (50%) and hypothyroidism (14.6%). Results of the DiaRem scoring system showed 0-2 points in 15.6% patients, 3-7 points in 39.6% patients, 8-12 in 26% patients, 13-17 in 9.4% patients, and 18-22 in 9.4% patients. The lowest DiaRem score was associated with a higher value of BMI, shorter DM duration, and lower mean values of HbA1c and FBG post-surgery.

CONCLUSION

Consistent with the literature, our results indicated that those with an increased BMI, shorter duration of DM, and lower values of HbA1c post-FBG had a greater chance of diabetes remission postoperatively.

摘要

引言

二型糖尿病（T2DM）缓解已被视为肥胖症手术给病态肥胖糖尿病患者带来的一项额外益处。有许多评分系统用于识别预测糖尿病缓解的因素；然而，目前尚无普遍适用的评分系统。

目的

本研究旨在测试DiaRem评分系统对沙特阿拉伯布赖代法赫德国王专科医院接受肥胖症手术的病态肥胖患者T2DM缓解情况的预测敏感性。

方法

这是在沙特阿拉伯布赖代法赫德国王专科医院进行的一项非随机对照试验。首次筛查时的就诊患者根据纳入标准入选。根据给定参数收集数据，如性别、年龄、体重指数（BMI）、糖尿病（DM）病程、用药情况（胰岛素、口服降糖药、若使用则片剂数量或未用药）、合并症情况，如高血压和血脂异常、糖化血红蛋白（HbA1c）水平（手术前以及手术后第3、6和12个月）以及空腹血糖（FBG）水平（手术前后）。

结果

共纳入96例糖尿病患者（35例男性对61例女性），平均年龄46.5岁。腹腔镜袖状胃切除术是最常施行的手术。最常见的合并症是高血压（50%）和甲状腺功能减退（14.6%）。DiaRem评分系统结果显示，15.6%的患者得0 - 2分，39.6%的患者得3 - 7分，26%的患者得8 - 12分，9.4%的患者得13 - 17分，9.4%的患者得18 - 22分。最低的DiaRem评分与更高的BMI值、更短的DM病程以及术后更低的HbA1c和FBG平均值相关。