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单吻合口胃旁路术与袖状胃切除术治疗2型糖尿病缓解情况的比较:一项3年随访的回顾性分析

One Anastomosis Gastric Bypass vs. Sleeve Gastrectomy in the Remission of Type 2 Diabetes Mellitus: A Retrospective Analysis on 3 Years of Follow-Up.

作者信息

Gambardella Claudio, Mongardini Federico Maria, Paolicelli Maddalena, Lucido Francesco Saverio, Tolone Salvatore, Brusciano Luigi, Parisi Simona, Esposito Rosetta, Iovino Francesco, Nazzaro Luca, Pizza Francesco, Docimo Ludovico

机构信息

Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", 80131 Naples, Italy.

Department of Surgery, Aslnapoli2nord, Hospital "A. Rizzoli", 80076 Naples, Italy.

出版信息

J Clin Med. 2024 Feb 4;13(3):899. doi: 10.3390/jcm13030899.

Abstract

Obesity is a prevalent condition associated with various comorbidities, impacting mortality, fertility, and quality of life. Its relationship with type 2 diabetes mellitus (DMII) is well established, with nearly 44% prevalence. Bariatric surgery has proven crucial for treating both obesity and DMII. The comparison between surgical techniques, such as sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB), remains controversial in terms of glycemic control efficacy. This retrospective study aimed to assess DMII remission efficacy between SG and OAGB after 36 months. From January 2016 to September 2020, 201 patients who underwent SG and OAGB for morbid obesity associated with DMII were accurately followed-up with for 36 months, focusing on %HbA1c, DMII remission, anthropometric results, and nutrient deficiency. Although DMII remission did not exhibit statistical significance between the groups (82% vs. 93%, SG vs. OAGB, = 0.051), OAGB demonstrated a more robust association with glycemic control (Odds Ratio 0.51) throughout the entire follow-up and yielded superior anthropometric outcomes. Notably, nutrient deficiencies, excluding cholecalciferol, iron, and riboflavin, did not show significant intergroup differences. This study contributes valuable insights into the extended-term efficacy of SG and OAGB in DMII remission. The nuanced findings underscore the multifaceted nature of metabolic outcomes, suggesting that factors beyond weight loss influence diabetes resolution. Larger comparative studies are warranted to comprehensively address this issue.

摘要

肥胖是一种普遍存在的病症,与多种合并症相关,影响死亡率、生育能力和生活质量。其与2型糖尿病(DMII)的关系已得到充分证实,患病率近44%。减肥手术已被证明对治疗肥胖症和DMII都至关重要。在血糖控制疗效方面,诸如袖状胃切除术(SG)和单吻合口胃旁路术(OAGB)等手术技术之间的比较仍存在争议。这项回顾性研究旨在评估36个月后SG和OAGB在DMII缓解方面的疗效。从2016年1月至2020年9月,对201例因与DMII相关的病态肥胖而接受SG和OAGB手术的患者进行了为期36个月的精确随访,重点关注糖化血红蛋白百分比(%HbA1c)、DMII缓解情况、人体测量结果和营养缺乏情况。尽管两组之间的DMII缓解情况没有统计学意义(SG组为82%,OAGB组为93%,P = 0.051),但在整个随访期间,OAGB与血糖控制的关联更为显著(优势比为0.51),并且在人体测量结果方面表现更优。值得注意的是,除胆钙化醇、铁和核黄素外,营养缺乏情况在组间没有显著差异。这项研究为SG和OAGB在DMII缓解方面的长期疗效提供了有价值的见解。这些细微的研究结果强调了代谢结果的多面性,表明除体重减轻外的其他因素也会影响糖尿病的缓解。需要进行更大规模的比较研究来全面解决这个问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8619/10856683/509c4d0cee2f/jcm-13-00899-g001.jpg

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