Omentectomy in addition to gastric bypass surgery and influence on insulin sensitivity: A randomized double blind controlled trial
Omentectomy in addition to gastric bypass surgery and influence on insulin sensitivity: A randomized double blind controlled trial
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DOI：
10.1016/j.clnu.2014.01.004
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发表时间：
2014-12-01
影响因子：
6.3
通讯作者：
Hoffstedt, Johan
中科院分区：
文献类型：
--
作者：
Andersson, Daniel P.;Thorell, Anders;Hoffstedt, Johan
背景与目的：内脏脂肪组织蓄积与胰岛素抵抗和心血管疾病有关。本研究的目的是阐明是否去除了大量的内脏脂肪网膜切除术与Roux en-Y胃旁路手术（RYGB）的结果在增强改善胰岛素敏感性相比，胃旁路手术单独。方法：81个肥胖的女性被列入研究中的RYGB。他们被随机分配到RYGB或RYGB联合网膜切除术。术前用高胰岛素正葡萄糖钳夹法测定胰岛素敏感性，术后2年复查。主要结果测量是胰岛素敏感性和次要结果的措施，包括心脏代谢的危险factors.Results：两年的体重减轻是深刻的，但网膜切除术的影响。在干预前，两组之间没有临床或代谢差异。2年后，非网膜切除术组（6.7 +/- 1.6 mg/kg体重/分钟）和网膜切除术组（6.6 +/- 1.5 mg/kg体重/分钟）的主要结局指标胰岛素敏感性差异不显著。也没有任何的心脏代谢的危险因素，是次要的结果measurements.Conclusion显着不同：除了网膜切除术胃旁路手术不给长期的胰岛素敏感性或心脏代谢的危险因素的增量效应。胃旁路手术之外的网膜切除术的临床有效性是非常值得怀疑的。(C)2014爱思唯尔有限公司和欧洲临床营养与代谢学会。All rights reserved.
Background & aims: Accumulation of visceral adipose tissue is associated with insulin resistance and cardio-vascular disease. The aim of this study was to elucidate whether removal of a large amount of visceral fat by omentectomy in conjunction with Roux en-Y gastric bypass operation (RYGB) results in enhanced improvement of insulin sensitivity compared to gastric bypass surgery alone.Methods: Eighty-one obese women scheduled for RYGB were included in the study. They were randomized to RYGB or RYGB in conjunction with omentectomy. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp before operation and sixty-two women were also reexamined 2 years post-operatively. The primary outcome measure was insulin sensitivity and secondary outcome measures included cardio-metabolic risk factors.Results: Two-year weight loss was profound but unaffected by omentectomy. Before intervention, there were no clinical or metabolic differences between the two groups. The difference in primary outcome measure, insulin sensitivity, was not significant between the non-omentectomy (6.7 +/- 1.6 mg/kg body weight/minute) and omentectomy groups (6.6 +/- 1.5 mg/kg body weight/minute) after 2 years. Nor did any of the cardio-metabolic risk factors that were secondary outcome measures differ significantly.Conclusion: Addition of omentectomy to gastric bypass operation does not give an incremental effect on long term insulin sensitivity or cardio-metabolic risk factors. The clinical usefulness of omentectomy in addition to gastric bypass operation is highly questionable. (C) 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.