Sio Yueh-Chu, Chen Ching-Yi, Huang Yu-Min, Lee Wei-Jei, Hur Kyoung Yul, Kasama Kazunori, Cheng Anton Kui Sing, Lee Ming-Hsien, Simon Kin-Hung Wong, Soong Tien-Chou, Lee Kuo-Ting, Lomanto Davide, Lakdawala Muffazal, Su Yen-Hao, Wang Weu, Chen Hsi-Hsien
Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Clin Kidney J. 2024 Oct 9;17(10):sfae260. doi: 10.1093/ckj/sfae260. eCollection 2024 Oct.
Metabolic surgery is recognized for its effectiveness in weight loss and improving outcomes for individuals with type 2 diabetes mellitus (T2DM). However, its impact on renal function, especially in multi-ethnic Asian populations, remains underexplored. This study investigates mid- and long-term renal outcomes following metabolic surgery in Asian patients with T2DM.
This retrospective cohort study utilized data from the Asian Diabetes Surgery Study (ADSS), involving T2DM patients aged 20-79 who underwent metabolic surgery from 2008 to 2015. The primary outcome was the change in estimated glomerular filtration rate (eGFR) at 1, 3, and 5 years post-surgery, with adjustments for confounders. Secondary outcomes included changes in chronic kidney disease (CKD) stages and the relationship between weight loss and eGFR changes. Data were analyzed using univariate and multivariable regression analyses, along with the McNemar test.
The study included 1513 patients with a mean age of 42.7 years. The results revealed that a significant improvement in eGFR was observed at 1-year post-surgery (112.4 ± 32.0 ml/min/1.73 m², < .001), with a shift toward less severe CKD stages. However, this improvement was not sustained at 3 and 5 years. No significant correlation was found between weight loss and eGFR changes at 1-year follow-up.
Metabolic surgery significantly improves renal function at 1 year postoperatively in Asian individuals with T2DM, highlighting its potential benefits beyond glycemic control and weight loss. The long-term effects on renal function require further investigation.
代谢手术因其在减肥和改善2型糖尿病（T2DM）患者预后方面的有效性而得到认可。然而，其对肾功能的影响，尤其是在多民族亚洲人群中，仍未得到充分研究。本研究调查了亚洲T2DM患者接受代谢手术后的中长期肾脏结局。
这项回顾性队列研究利用了亚洲糖尿病手术研究（ADSS）的数据，该研究涉及2008年至2015年接受代谢手术的20 - 79岁T2DM患者。主要结局是术后1年、3年和5年估计肾小球滤过率（eGFR）的变化，并对混杂因素进行了调整。次要结局包括慢性肾脏病（CKD）分期的变化以及体重减轻与eGFR变化之间的关系。数据采用单变量和多变量回归分析以及McNemar检验进行分析。
该研究纳入了1513例平均年龄为42.7岁的患者。结果显示，术后1年eGFR有显著改善（112.4 ± 32.0 ml/min/1.73 m²，P <.001），CKD分期向较轻阶段转变。然而，这种改善在3年和5年时并未持续。在1年随访时，未发现体重减轻与eGFR变化之间存在显著相关性。
代谢手术在术后1年可显著改善亚洲T2DM患者的肾功能，突出了其在血糖控制和体重减轻之外的潜在益处。对肾功能的长期影响需要进一步研究。
