Background characteristics and diabetes remission after laparoscopic sleeve gastrectomy in Japanese patients with type 2 diabetes stratified by BMI: subgroup analysis of J-SMART
Background characteristics and diabetes remission after laparoscopic sleeve gastrectomy in Japanese patients with type 2 diabetes stratified by BMI: subgroup analysis of J-SMART
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按 BMI 分层的日本 2 型糖尿病患者的背景特征和腹腔镜袖状胃切除术后糖尿病缓解：J-SMART 亚组分析
DOI：
10.1007/s13340-020-00487-x
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发表时间：
2021
影响因子：
2.2
通讯作者：
Masaki
中科院分区：
文献类型：
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作者：
Saiki Atsuhito;Yamaguchi Takashi;Sasaki Akira;Naitoh Takeshi;Matsubara Hisahiro;Yokote Koutaro;Okazumi Shinichi;Ugi Satoshi;Yamamoto Hiroshi;Ohta Masayuki;Ishigaki Yasushi;Kasama Kazunori;Seki Yosuke;Tsujino Motoyoshi;Shirai Kohji;Miyazaki Yasuhiro;Masaki
目的：J-SMART研究是日本第一次对接受腹腔镜袖状胃切除术（LSG）的患者进行全国性调查。我们进行了一项J-SMART亚组分析，重点关注BMI为32-34.9 kg/m2和BMI更高的患者之间患者背景和糖尿病缓解的差异。MethodsIn this multi-institutional retrospective study at 10 certified beariatric institutions，203 Japanese with type 2 diabetes（T2 D）and BMI为32 kg/m2或更高进行了分析（平均年龄：49.2岁，BMI：43.8 kg/m2，HbA 1c：7.6%）。根据术前BMI将患者分为5组。结果BMI 32.0-34.9组的背景特征是较高的调整后HbA 1c，较高的内脏/皮下脂肪面积比，较高的糖尿病视网膜病变患病率，较高的胰岛素使用频率和较低的血清C肽。尽管BMI 32.0-34.9组的2年总体重减轻百分比（21.7%）和糖尿病完全缓解（CR）率（52.4%）较低，但糖尿病改善率为81.0%，HbA 1c和降糖药物数量的下降与BMI较高的患者相当或更大。较高的BMI和不使用胰岛素是糖尿病CR的重要独立预测因素。结论体重在32 ~ 34.9kg/m2的糖尿病患者内脏肥胖、T2 D及并发症较重，内源性胰岛素分泌能力较低。LSG应被视为BMI 32-34.9 kg/m2患者的治疗选择，以改善糖尿病控制。
AimThe J-SMART study was the first national survey of Japanese patients undergoing laparoscopic sleeve gastrectomy (LSG). We performed a subgroup analysis of J-SMART focusing on the differences in patient background and diabetes remission between patients with BMI 32–34.9 kg/m2and those with higher BMI.MethodsIn this multi-institutional retrospective study at 10 certified bariatric institutions, 203 Japanese with type 2 diabetes (T2D) and BMI of 32 kg/m2or higher were analyzed (mean age: 49.2 years, BMI: 43.8 kg/m2, HbA1c: 7.6%). Patients were stratified into five groups according to preoperative BMI.ResultsBackground characteristics in BMI 32.0–34.9 group were higher adjusted HbA1c, higher visceral/subcutaneous fat area ratio, higher prevalence of diabetic retinopathy, higher frequency of insulin use and lower serum C-peptide. Although 2-year percent total weight loss (21.7%) and diabetes complete remission (CR) rate (52.4%) were lower in BMI 32.0–34.9 group, diabetes improvement rate was 81.0%, and the decrease in HbA1c and number of antidiabetic drugs were comparable or greater than those with higher BMI. Higher BMI and no insulin use were significant independent predictors of diabetes CR. No significant independent predictor was identified for diabetes improvement.ConclusionThe patients with 32–34.9 kg/m2were characterized by more severe visceral obesity, T2D and the complications, and lower intrinsic insulin secretion capacity. LSG should be considered as a treatment option for patients with BMI 32–34.9 kg/m2, to improve diabetes control.
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保留β细胞功能是日本肥胖糖尿病患者腹腔镜袖状胃切除术后糖尿病缓解的主要决定因素。
影响因子：
2
作者：
S. Ugi;K. Morino;Tsuyoshi Yamaguchi;Hiroshi Yamamoto;Sachiko Kaida;I. Miyazawa;Daisuke Sato;Osamu Sekine;Y. Fujita;A. Kashiwagi;M. Tani;H. Maegawa
通讯作者：
H. Maegawa
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影响因子：
3
作者：
Kramer, Holly;Cao, Guichan;Durazo-Arvizu, Ramon
通讯作者：
Durazo-Arvizu, Ramon
影响因子：
2.2
作者：
Araki, Eiichi;Goto, Atsushi;Yoshioka, Narihito
通讯作者：
Yoshioka, Narihito
影响因子：
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作者：
Singla, Rajiv;Murthy, Mithun;Gupta, Yashdeep
通讯作者：
Gupta, Yashdeep