Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
BMC Endocr Disord. 2022 Oct 26;22(1):260. doi: 10.1186/s12902-022-01171-8.
Several studies on various bariatric surgeries involving patients with type 2 diabetes mellitus (T2DM) showed an overall rate of remission of hyperglycemia. However, there is little known about predictive factors on remission after different types of surgeries. The aim of this study was to identify the T2DM remission rate and to determine the effects of preoperative factors characteristics of remission of type 2 diabetes in Iran.
We conducted a retrospective analysis of 1351 patients with T2DM operated by three different types of surgeries (Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and One Anastomosis Gastric Bypass (OAGB)). Diabetes remission was defined according to the American Diabetes Association (ADA) criteria. Binary logistic regression analyses were employed.
A total of 1351 patients, 675 patients (50.0%) undergoing OAGB, 475 (35.2%) RYGB, and 201 (14.9%) SG. 80.6%, 84.2% of OAGB, 81.7%, 82.6% of RYGB, and 77.1%, 81.5% of SG participants were in T2DM remission after 1 and 3 years, respectively. 1- and 3-year remission were associated with preoperative age, duration of T2DM, FBS and HbA1c, BMI, insulin therapy, and a family history of obesity (p < 0.05).
The remission of T2DM after RYGB, SG, and OAGB surgery is dependent on various preoperative factors. Patients with younger age, shorter duration of T2DM, lower preoperative HbA1c and FBS, higher BMI, who were not on insulin therapy, and not having a family history of obesity were the best candidates to achieve a prolonged diabetes remission.
多项涉及 2 型糖尿病（T2DM）患者的减重手术研究表明，高血糖缓解率总体较高。然而，对于不同类型手术的缓解预测因素知之甚少。本研究旨在确定 T2DM 缓解率，并确定伊朗不同类型手术中 T2DM 缓解的术前因素特征。
我们对 1351 例接受三种不同类型手术（Roux-en-Y 胃旁路术（RYGB）、袖状胃切除术（SG）和单吻合胃旁路术（OAGB））治疗的 T2DM 患者进行了回顾性分析。根据美国糖尿病协会（ADA）标准定义糖尿病缓解。采用二项逻辑回归分析。
共纳入 1351 例患者，其中 OAGB 组 675 例（50.0%），RYGB 组 475 例（35.2%），SG 组 201 例（14.9%）。OAGB、RYGB 和 SG 组分别有 80.6%、84.2%、77.1%和 81.5%的患者在术后 1 年和 3 年时达到 T2DM 缓解，1 年和 3 年缓解与术前年龄、T2DM 病程、FBS 和 HbA1c、BMI、胰岛素治疗和肥胖家族史有关（p<0.05）。
RYGB、SG 和 OAGB 手术后 T2DM 的缓解与多种术前因素有关。年龄较小、T2DM 病程较短、术前 HbA1c 和 FBS 较低、BMI 较高、未接受胰岛素治疗且无肥胖家族史的患者最有可能实现糖尿病的长期缓解。
