Queiroz Suelen, Gadelha Júlia Gonçalves, Husain Noor, Gutu Cristina Sicorschi
Ponta Grossa State University, Ponta Grossa, Brazil.
Afya Faculty of Medical Sciences of Paraíba, Paraíba, Brazil.
Obes Surg. 2025 May 16. doi: 10.1007/s11695-025-07858-w.
Obesity and type 2 diabetes mellitus (T2DM) are global health crises, with bariatric surgery emerging as a key intervention. However, the comparative efficacy of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) in achieving diabetes remission remains debated.
This PRISMA-compliant meta-analysis included three randomized controlled trials (RCTs, n = 613 patients) comparing RYGB and SG in adults with severe obesity (BMI ≥30 kg/m²) and T2DM.
diabetes remission (HbA1c 6.0%). Risk of bias was assessed via Cochrane RoB-2 tool; statistical analysis used fixed-effect models (I²=0%).
RYGB demonstrated superior diabetes remission rates vs. SG (OR 2.77, 95% CI 1.83-4.20, p0.001), with no heterogeneity. Subgroup analyses confirmed consistency across studies. Mean follow-up was ≤5 years; baseline demographics were comparable (mean age 46.2 years, 53.4% male).
RYGB significantly outperforms SG in achieving T2DM remission, likely due to its combined restrictivemalabsorptive mechanisms and metabolic hormonal effects. These findings support RYGB as the preferred surgical option for obese patients with T2DM, though long-term studies are needed to assess durability.
肥胖症和2型糖尿病（T2DM）是全球性的健康危机，减肥手术已成为一项关键干预措施。然而，Roux-en-Y胃旁路术（RYGB）与袖状胃切除术（SG）在实现糖尿病缓解方面的相对疗效仍存在争议。
这项符合PRISMA标准的荟萃分析纳入了三项随机对照试验（RCT，n = 613例患者），比较了RYGB和SG对重度肥胖（BMI≥30 kg/m²）且患有T2DM的成年人的疗效。
糖尿病缓解（糖化血红蛋白HbA1c<6.0%）。通过Cochrane RoB-2工具评估偏倚风险；统计分析采用固定效应模型（I²=0%）。
与SG相比，RYGB的糖尿病缓解率更高（OR 2.77，95%CI 1.83-4.20，p<0.001），且无异质性。亚组分析证实了各研究结果的一致性。平均随访时间≤5年；基线人口统计学特征具有可比性（平均年龄46.2岁，男性占53.4%）。
在实现T2DM缓解方面，RYGB显著优于SG，这可能归因于其兼具限制吸收和代谢激素效应的机制。这些发现支持RYGB作为肥胖T2DM患者的首选手术方式，不过仍需长期研究来评估其疗效的持久性。
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