Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Department of Public Health & Maternal and Child Health, Universidad Complutense de Madrid, Madrid, Spain
BMJ Open Diabetes Res Care. 2024 Aug 3;12(4):e004351. doi: 10.1136/bmjdrc-2024-004351.
The objectives of this study were to examine temporal trends in the incidence of bariatric surgery (Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG)) in patients with and without type 2 diabetes mellitus (T2DM). Outcomes of hospitalization and the impact of T2DM on these outcomes were also analyzed.
We performed an observational study with the Spanish national hospital discharge database. Obese patients with and without T2DM who underwent RYGB and SG between 2016 and 2022 were identified. Propensity score matching (PSM) and logistic regression were used to compare patients with and without T2DM and to evaluate the effect of T2DM and other variables on outcomes of surgery. A variable "severity" was created to cover patients who died in hospital or were admitted to the intensive care unit (ICU).
A total of 32,176 bariatric surgery interventions were performed (28.86% with T2DM). 31.57% of RYGBs and 25.53% of SG patients had T2DM. The incidence of RYGB and SG increased significantly between 2016 and 2022 (p<0.001), with a higher incidence in those with T2DM than in those without (incidence rate ratio 4.07 (95% CI 3.95 to 4.20) for RYGB and 3.02 (95% CI 2.92 to 3.14) for SG). In patients who underwent SG, admission to the ICU and severity were significantly more frequent in patients with T2DM than in those without (both p<0.001). In the multivariate analysis, having T2DM was associated with more frequent severity in those who received SG (OR 1.23; 95% CI 1.07 to 1.42).
Between 2016 and 2022, bariatric surgery procedures performed in Spain increased in patients with and without T2DM. More interventions were performed on patients with T2DM than on patients without T2DM. RYGB was the most common procedure in patients with T2DM. The presence of T2DM was associated with more severity after SG.
本研究旨在探讨伴有和不伴有 2 型糖尿病（T2DM）的患者行减重手术（胃旁路术[RYGB]和袖状胃切除术[SG]）的发病率随时间的变化趋势。还分析了住院治疗结果以及 T2DM 对这些结果的影响。
我们进行了一项观察性研究，使用了西班牙国家住院数据库。确定了 2016 年至 2022 年间患有 T2DM 和不患有 T2DM 而接受 RYGB 和 SG 的肥胖患者。采用倾向评分匹配（PSM）和逻辑回归比较患有和不患有 T2DM 的患者，并评估 T2DM 和其他变量对手术结果的影响。创建了一个“严重程度”变量，以涵盖在医院死亡或入住重症监护病房（ICU）的患者。
共进行了 32176 例减重手术干预（28.86%患有 T2DM）。RYGB 患者中 31.57%和 SG 患者中 25.53%患有 T2DM。2016 年至 2022 年间，RYGB 和 SG 的发病率显著增加（p<0.001），患有 T2DM 的患者发病率高于不患有 T2DM 的患者（发病率比 4.07（95%CI 3.95 至 4.20），SG 为 3.02（95%CI 2.92 至 3.14））。在接受 SG 的患者中，患有 T2DM 的患者 ICU 入院和严重程度显著高于不患有 T2DM 的患者（均 p<0.001）。多变量分析显示，接受 SG 的患者中 T2DM 与更频繁的严重程度相关（OR 1.23；95%CI 1.07 至 1.42）。
2016 年至 2022 年间，在西班牙进行的减重手术在患有和不患有 T2DM 的患者中均有所增加。在患有 T2DM 的患者中进行的手术多于不患有 T2DM 的患者。RYGB 是 T2DM 患者最常见的手术。SG 后，T2DM 的存在与更严重的病情相关。
