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体重指数<35kg/m²的2型糖尿病患者的单吻合口胃旁路手术:一项多中心回顾性队列研究。

One anastomosis gastric bypass surgery in Type2 diabetes patients with body mass index < 35 kg/m: A multi-center retrospective cohort study.

作者信息

Amirbeigi Alireza, Abbaslou Fereshteh, Talebpour Mohammad, Soroush Ahmadreza, Elyasinia Fezzeh, Zabihi Mahmoudabadi Hossein, Najjari Khosrow

机构信息

Department of General Surgery, School of Medicine, Kerman University of Medical, Iran.

Clinical Research Development Unit, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

Ann Med Surg (Lond). 2022 Jun 27;79:104102. doi: 10.1016/j.amsu.2022.104102. eCollection 2022 Jul.

Abstract

INTRODUCTION

Bariatric surgeries have shown efficacy in weight reduction, glycemic control and improvement of type-2 diabetes (T2DM) in patients with obesity. We aimed to assess the efficacy of one anastomosis gastric bypass surgery (OAGB) in T2DM patients with body mass index (BMI) < 35 kg/m within a year after surgery.

METHODS

In this multicenter retrospective cohort study, 14 T2DM patients with BMI <35 kg/m (females, %: 71.4% (10 of 14), and age, mean (standard deviation): 51.2 (12.3) years) who had underwent OAGB surgery by the same surgeon, were followed at intervals of one, three, six, and 12 months after surgery. The remission rates of T2DM were calculated and the metabolic indices were compared using paired -test and Wilcoxon rank test.

RESULTS

No adverse outcomes were detected 12 months after surgery. Within six months, seven (50%) patients underwent remission (one (7.1%) within one, three (21.4%) within three, and three (21.4%) within six months). Post-operative weight (p < 0.001) and fasting blood glucose (p < 0.01) in all time periods were significantly lower compared to pre-operative values. Hemoglobin A1C (HbA1C) was significantly lower at three- and six-month intervals (p < 0.05) but not at twelve months (p = 0.2). Thyroid-stimulating hormone and triglyceride levels were lower at six months compared to pre-surgical levels (p < 0.05) but cholesterol levels were not different in any of time points (p > 0.05).

CONCLUSION

OAGB surgery is associated with weight reduction, glycemic control and a 50% remission rate within six months in patients with diabetes and BMI <35 kg/m.

摘要

引言

减肥手术已显示出在肥胖患者体重减轻、血糖控制及改善2型糖尿病(T2DM)方面的疗效。我们旨在评估单吻合口胃旁路手术(OAGB)对体重指数(BMI)<35kg/m²的T2DM患者术后一年内的疗效。

方法

在这项多中心回顾性队列研究中,14例BMI<35kg/m²的T2DM患者(女性占71.4%(14例中的10例),平均年龄(标准差):51.2(12.3)岁)由同一位外科医生实施了OAGB手术,术后分别在1、3、6和12个月进行随访。计算T2DM的缓解率,并使用配对t检验和Wilcoxon秩和检验比较代谢指标。

结果

术后12个月未检测到不良结局。6个月内,7例(50%)患者病情缓解(1例(7.1%)在1个月内,3例(21.4%)在3个月内,3例(21.4%)在6个月内)。所有时间段的术后体重(p<0.001)和空腹血糖(p<0.01)均显著低于术前值。糖化血红蛋白(HbA1C)在3个月和6个月时显著降低(p<0.05),但在12个月时未降低(p=0.2)。促甲状腺激素和甘油三酯水平在6个月时低于术前水平(p<0.05),但胆固醇水平在任何时间点均无差异(p>0.05)。

结论

对于糖尿病且BMI<35kg/m²的患者,OAGB手术与体重减轻、血糖控制及6个月内50%的缓解率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb1/9289504/da7fe54b53b5/gr1a.jpg

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