Department of Internal Medicine, Endocrinology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.
Prim Care Diabetes. 2023 Jun;17(3):273-277. doi: 10.1016/j.pcd.2023.03.001. Epub 2023 Mar 7.
Obesity is a global concern with several health-related complications. Bariatric surgeries are major treatment options in patients with obesity and other comorbidities. This study aims to investigate the effects of sleeve gastrectomy on metabolic indexes, hyperechogenic liver changes, inflammatory state, diabetes, and other obesity-related comorbidities remission after the sleeve gastrectomy.
This prospective study was conducted on patients with obesity candidates for laparoscopic sleeve gastrectomy. Patients were followed for one year after the surgery. Comorbidities, metabolic and inflammatory parameters were assessed before and one- year after the surgery.
137 patients (16 males, 44 in the DM group) underwent sleeve gastrectomy. One year after the study, obesity-related comorbidities improved significantly; diabetes had complete remission in 22.7% and partial remission in 63.6% of patients. Hyper-cholesterolemia, hyper-triglyceridemia, and hyper-uricemia also improved in 45.6%, 91.2%, and 69% of the patients. Metabolic syndrome indexes improved in 17.5% of the patients. Also, the prevalence of hyperechogenic changes in the liver has declined from 21% before the surgery to 1.5% after that. Based on logistic regression analysis, increased levels of HbA1C reduced the chance of diabetes remission by 0.9%. In comparison, every unit of increased BMI before the surgery improved the case of diabetes remission by 16%.
Laparoscopic sleeve gastrectomy is a safe and effective treatment option in patients with obesity and diabetes. Laparoscopic sleeve gastrectomy alleviates BMI and insulin resistance and effectively improves other obesity-related comorbidities such as Hypercholesterolemia, hyper-triglyceridemia, hyper-uricemia, and hyperechogenic changes of the liver. HbA1C and BMI before the surgery are notable predictors of diabetes remission within the first year after the surgery.
肥胖是一个全球性问题,与多种健康相关的并发症有关。减重手术是肥胖症及其他合并症患者的主要治疗选择。本研究旨在探讨袖状胃切除术对代谢指标、肝脏回声改变、炎症状态、糖尿病和其他肥胖相关合并症缓解的影响。
这项前瞻性研究针对的是接受腹腔镜袖状胃切除术的肥胖症候选患者。患者在手术后随访一年。在手术前和手术后一年评估合并症、代谢和炎症参数。
137 名患者(16 名男性,44 名患有糖尿病)接受了袖状胃切除术。研究一年后,与肥胖相关的合并症显著改善;22.7%的患者糖尿病完全缓解,63.6%的患者糖尿病部分缓解。高胆固醇血症、高三酰甘油血症和高尿酸血症也分别有 45.6%、91.2%和 69%的患者得到改善。17.5%的患者代谢综合征指数得到改善。此外,术前肝脏回声改变的发生率从 21%下降到 1.5%。基于逻辑回归分析,HbA1C 水平升高会使糖尿病缓解的机会降低 0.9%。相比之下,术前 BMI 每增加一个单位,糖尿病缓解的可能性就会增加 16%。
腹腔镜袖状胃切除术是肥胖合并糖尿病患者安全有效的治疗选择。腹腔镜袖状胃切除术减轻了 BMI 和胰岛素抵抗,有效改善了其他肥胖相关合并症,如高胆固醇血症、高三酰甘油血症、高尿酸血症和肝脏回声改变。手术前的 HbA1C 和 BMI 是手术后第一年糖尿病缓解的显著预测因子。