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腹腔镜袖状胃切除术治疗糖尿病缓解和心血管风险下降的持续疗效评估:一项初步的 1 年研究。

Evaluation of Persistent Efficacy of Diabetes Remission and Decline of Cardiovascular Risk After Laparoscopic Sleeve Gastrectomy: a Preliminary 1-Year Study.

机构信息

Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan.

Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

Obes Surg. 2022 Oct;32(10):3289-3297. doi: 10.1007/s11695-022-06201-x. Epub 2022 Jul 23.

Abstract

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) is a relative safe procedure in bariatric surgery. However, relatively few studies had been assessed its comprehensive efficacies. In the current study, the efficacies of LSG were comprehensively explored on glycemic control and cardiovascular disease (CVD) risk reduction.

METHODS

A total of 95 obese patients, who owned body mass index (BMI) of more than 35, were recruited. All of them primarily underwent LSG from 2014 to 2016. Type 2 diabetes mellitus (T2DM) remission was defined as levels of glycated hemoglobin (A1C) and fasting blood glucose (FBG) of less than 6.4% and 125 mg/dL, respectively. The further efficacies of LSG on CVD and coronary heart disease (CHD) risks were explored by using original- and recalibrated Framingham 10-year CHD risk scores and the other 3 well-established CVD risk prediction models.

RESULTS

Systolic blood pressure (SBP), serum FBG, A1C, triglyceride (TG), BMI, and body weight showed significantly declined and high-density lipoprotein-cholesterol (HDL) displayed twice higher than beginning level after LSG. The 71 of 95 patients with obesity were T2DM; 62 of them exhibited persistent DM remission until 1 year after LSG. Cardiovascular age, general cardiovascular risk (GCVR), and atherosclerotic cardiovascular disease risk (ASCVD) also showed significant decrements after LSG. We also observed significant reductions in estimated CVD and CHD risks.

CONCLUSION

LSG resulted in a persistent T2DM remission and corrected metabolic abnormalities. Subsequently, LSG also benefits declined risks of CVD and 10-year CHD developments. LSG may be helpful for primary CVD care in obese patients with BMI of more than 35.

摘要

背景

腹腔镜袖状胃切除术(LSG)是一种相对安全的减重手术。然而,很少有研究评估其综合疗效。在本研究中,综合探讨了 LSG 在血糖控制和降低心血管疾病(CVD)风险方面的疗效。

方法

共纳入 95 名肥胖患者,BMI 均大于 35。所有患者均于 2014 年至 2016 年接受了 LSG。2 型糖尿病(T2DM)缓解定义为糖化血红蛋白(A1C)和空腹血糖(FBG)水平分别小于 6.4%和 125mg/dL。使用原始和重新校准的Framingham 10 年冠心病风险评分以及其他 3 种成熟的 CVD 风险预测模型,进一步探讨了 LSG 对 CVD 和冠心病(CHD)风险的影响。

结果

LSG 后,收缩压(SBP)、血清 FBG、A1C、三酰甘油(TG)、BMI 和体重均显著下降,高密度脂蛋白胆固醇(HDL)水平升高了一倍。95 名肥胖患者中,71 名患有 T2DM;62 名患者在 LSG 后 1 年内仍持续缓解 DM。LSG 后心血管年龄、总体心血管风险(GCVR)和动脉粥样硬化性心血管疾病风险(ASCVD)也显著降低。我们还观察到估计的 CVD 和 CHD 风险显著降低。

结论

LSG 可导致 T2DM 持续缓解和代谢异常纠正。随后,LSG 还降低了 CVD 和 10 年 CHD 发展的风险。LSG 可能有助于 BMI 大于 35 的肥胖患者进行初级 CVD 管理。

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