减重手术后2型糖尿病患者动脉粥样硬化指数的变化趋势：一项全国队列研究
The trend of atherogenic indices in patients with type 2 diabetes after bariatric surgery: a national cohort study.
作者信息
Seyedi Arsalan, Rabizadeh Soghra, Abbaspour Faeze, Karimpour Reyhan Sahar, Asgari Soran Nasrin, Nabipoor Ali, Yadegar Amirhossein, Mohammadi Fatemeh, Hashemi Rana, Qahremani Reihane, Saffari Elahe, Riazi Sajedeh, Sarv Fatemeh, Nakhjavani Manouchehr, Pazouki Abdolreza, Esteghamati Alireza
机构信息
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran, Iran.
School of Medicine, Tehran University of Medical Science, Tehran, Iran.
出版信息
Surg Obes Relat Dis. 2025 Apr;21(4):423-433. doi: 10.1016/j.soard.2024.10.022. Epub 2024 Oct 30.
BACKGROUND
Bariatric surgery has profound effects on weight loss, metabolic regulation, and gut hormone modulation, which make it an efficient tool for managing obesity and improving diabetes outcomes.
OBJECTIVES
The objective of this study is to evaluate the atherogenic indices, including atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli's risk index II (CRI-II), and lipoprotein combine index (LCI) in individuals with type 2 diabetes (T2D) living with excess weight, who have undergone bariatric surgery.
SETTING
Three types of surgery including one-anastomosis gastric bypass/mini gastric bypass (OAGB/MGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) were performed on patients with obesity and T2D in the period of August 2009 to February 2021 at the Surgical Department of Hazrat-e Rasool Hospital (University Hospital), Tehran, Iran.
METHODS
In this retrospective cohort, 1246 individuals with obesity and T2D who underwent 3 types of bariatric surgery including RYGB, SG, and OAGB/MGB were studied for 2years after the surgery; the data were derived from the National Iranian Obesity Surgery Database. Afterward, the trend of biochemical parameters, total weight loss (TWL%), and atherogenesis-related indices were evaluated from baseline up to 2years in 5 follow-up visits.
RESULTS
A total of 1246 patients with T2D and obesity who underwent bariatric surgery were included in this study. The trend of all atherogenesis-related indices, including AIP, LCI, CRI-II, and AC, showed a significant reduction (49.2%, 53.4%, 20.8%, 22%, respectively) 2years after the bariatric surgery (P < .05). In the 6-month follow-up, 1-year follow-up, and 2-year follow-up, 1023 (83.10%), 719 (57.70%), and 341 (27.36%) individuals participated, respectively. In addition, a significant increase in high-density lipoprotein cholesterol levels was observed 2years after the surgery in both sexes (P < .05).
CONCLUSIONS
The bariatric surgery significantly reduced the levels of atherogenic indices including AIP, CRI-II, LCI, and AC.
背景
减肥手术对体重减轻、代谢调节和肠道激素调节有深远影响，使其成为管理肥胖和改善糖尿病结局的有效工具。
目的
本研究的目的是评估接受减肥手术的超重2型糖尿病（T2D）患者的致动脉粥样硬化指数，包括血浆致动脉粥样硬化指数（AIP）、致动脉粥样硬化系数（AC）、卡斯泰利风险指数II（CRI-II）和脂蛋白综合指数（LCI）。
背景
2009年8月至2021年2月期间，伊朗德黑兰哈兹拉特-拉苏尔医院（大学医院）外科对肥胖和T2D患者进行了三种类型的手术，包括单吻合口胃旁路术/迷你胃旁路术（OAGB/MGB）、袖状胃切除术（SG）和Roux-en-Y胃旁路术（RYGB）。
方法
在这项回顾性队列研究中，对1246例接受RYGB、SG和OAGB/MGB三种减肥手术的肥胖和T2D患者术后2年进行了研究；数据来自伊朗国家肥胖手术数据库。随后，在5次随访中评估了从基线到2年的生化参数趋势、总体重减轻（TWL%）和动脉粥样硬化相关指数。
结果
本研究共纳入1246例接受减肥手术的T2D和肥胖患者。减肥手术后2年，所有动脉粥样硬化相关指数，包括AIP、LCI、CRI-II和AC的趋势均显著降低（分别为49.2%、53.4%、20.8%、22%）（P <.05）。在6个月随访、1年随访和2年随访中，分别有1023例（83.10%）、719例（57.70%）和341例（27.36%）患者参与。此外，术后2年两性的高密度脂蛋白胆固醇水平均显著升高（P <.05）。
结论
减肥手术显著降低了包括AIP、CRI-II、LCI和AC在内的致动脉粥样硬化指数水平。
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