干预下的缓解：代谢手术是终极解决方案吗？

Remission with an Intervention: Is Metabolic Surgery the Ultimate Solution?

机构信息

Metamor Institute, Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808, USA; Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia.

School of Cardiovascular and Metabolic Medicine & Sciences, King's College London; Bariatric and Metabolic Surgery King's College Hospital, Denmark Hill, London SE5 9RS, UK.

出版信息

Endocrinol Metab Clin North Am. 2023 Mar;52(1):65-88. doi: 10.1016/j.ecl.2022.09.002.

DOI:10.1016/j.ecl.2022.09.002

PMID:36754498

Abstract

Long-term remission of type 2 diabetes following lifestyle intervention or pharmacotherapy, even in patients with mild disease, is rare. Long-term remission following metabolic surgery however, is common and occurs in 23% to 98% depending on disease severity and type of surgery. Remission after surgery is associated with excellent glycemic control without reliance on pharmacotherapy, improvements in quality of life, and major reductions in microvascular and macrovascular complications. For patients with type 2 diabetes, early intervention with metabolic surgery, when beta cell function still remains intact, provides the greatest probability of long-term remission as high as 90% or more.

摘要

生活方式干预或药物治疗后，2 型糖尿病的长期缓解（即使是病情较轻的患者）也很少见。然而，代谢手术后的长期缓解较为常见，根据疾病严重程度和手术类型的不同，缓解率在 23%至 98%之间。手术后的缓解与无需药物治疗即可获得良好的血糖控制、改善生活质量以及显著减少微血管和大血管并发症有关。对于 2 型糖尿病患者，当β细胞功能仍然完整时，早期进行代谢手术干预可提供高达 90%或更高的长期缓解的最大可能性。