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代谢与减重手术对2型糖尿病患者糖尿病肾病的影响:一项系统评价与荟萃分析

The Impact of Metabolic and Bariatric Surgery on Diabetic Kidney Disease in Patients with Type 2 Diabetes: A Systematic Review and Meta-analysis.

作者信息

Einafshar Negar, Esparham Ali, Moghani Mahta Shari'at, Radboy Mahsa, Ghamari Mohammad Javad, Zandbaf Tooraj

机构信息

Innovative Medical Research Center, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Islamic Republic of Iran.

Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Obes Surg. 2025 Jan;35(1):329-340. doi: 10.1007/s11695-024-07612-8. Epub 2024 Dec 10.

DOI:10.1007/s11695-024-07612-8
PMID:39656373
Abstract

We aimed to determine the effect of metabolic and bariatric surgery (MBS) on the improvement of diabetic nephropathy (DN) in patients with obesity and type 2 diabetes (T2DM). A systematic search was performed in the PubMed, Embase, Scopus, and Web of Science databases. Meta-analysis of 31 studies with 2594 patients showed that urine albumin-to-creatinine ratio (UACR) was significantly reduced with a mean difference of - 28.19 mg/g (95% CI - 41.17, - 15.21, P-value < 0.001). In addition, subgroup analysis of studies showed a significant decrease after Roux-en-Y gastric bypass (RYGB) but not after sleeve gastrectomy (SG). These results suggest that MBS may lead to better kidney function and improvement in DN.

摘要

我们旨在确定代谢与减重手术(MBS)对肥胖合并2型糖尿病(T2DM)患者糖尿病肾病(DN)改善情况的影响。我们在PubMed、Embase、Scopus和Web of Science数据库中进行了系统检索。对31项研究共2594例患者进行的荟萃分析表明,尿白蛋白与肌酐比值(UACR)显著降低,平均差值为-28.19 mg/g(95%置信区间-41.17,-15.21,P值<0.001)。此外,研究的亚组分析显示,胃旁路术(RYGB)后有显著下降,但袖状胃切除术(SG)后未出现显著下降。这些结果表明,MBS可能会改善肾功能并改善DN。

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Front Endocrinol (Lausanne). 2024 Jan 31;15:1320627. doi: 10.3389/fendo.2024.1320627. eCollection 2024.
3
Impact of Weight Loss on the Severity of Albuminuria in Obese Diabetic Patients Undergoing Laparoscopic Sleeve Gastrectomy and One-Anastomosis Gastric Bypass.
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Int J Gen Med. 2022 Aug 4;15:6405-6413. doi: 10.2147/IJGM.S365113. eCollection 2022.
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Diabetes Remission in the Alliance of Randomized Trials of Medicine Versus Metabolic Surgery in Type 2 Diabetes (ARMMS-T2D).2 型糖尿病药物与代谢手术随机试验联盟中的糖尿病缓解(ARMMS-T2D)。
Diabetes Care. 2022 Jul 7;45(7):1574-1583. doi: 10.2337/dc21-2441.
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