Long-Term Follow-up of the Metabolic Profiles in Obese Patients With Type 2 Diabetes Mellitus After Roux-en-Y Gastric Bypass
Long-Term Follow-up of the Metabolic Profiles in Obese Patients With Type 2 Diabetes Mellitus After Roux-en-Y Gastric Bypass
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DOI：
10.1097/sla.0b013e3181d9769b
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发表时间：
2010-06-01
影响因子：
9
通讯作者：
Richards, William O.
中科院分区：
文献类型：
--
作者：
Kim, Seongmin;Richards, William O.
目的：本研究的目的是评估 Roux-en-Y 胃绕道术 (RYGBP) 对肥胖 2 型糖尿病 (T2DM) 患者的 2 种代谢性疾病（糖尿病和血脂异常）的影响。背景数据摘要：对于 RYGBP 后 T2DM 患者代谢和血脂谱的长期变化知之甚少。方法：这是对前瞻性收集的病态肥胖患者糖代谢和血脂谱数据的回顾性评价接受腹腔镜 RYGBP 治疗并服用抗糖尿病药物的 T2DM 患者。 结果：本研究共纳入 219 名平均 (+/- SD) 随访时间为 26.4 (+/- 12.8) 个月的患者。术后一年，平均空腹血糖从 152.8 降至 106.0 mg/dL，HGBA1c（糖化血红蛋白）从 7.6% 降至 6.1%，TC（总胆固醇）从 180.9 mg/dL 降至 172.0 mg/dL，TG（甘油三酯）从 208.0 降至 117.4 mg/dL，并且HDL-C（HDL-胆固醇）水平从 48.7 mg/dL 增加至 58.7 mg/dL。这些改善在手术后保持 2 至 4 年。年龄较大、T2DM 病程较长和胰岛素使用是导致 T2DM 失败的重要术前因素。术后总体体重减轻量与T2DM的改善或缓解相关（P = 0.053）。结论：腹腔镜RYGBP对肥胖T2DM患者的糖代谢和血脂成分具有有益的影响。持续体重减轻与术后肥胖 T2DM 患者维持正常血糖有关。
Objective: The goal of this study was to evaluate the effect of Roux-en-Y gastric bypass (RYGBP) on 2 metabolic disorders, diabetes and dyslipidemia, in obese type 2 diabetes mellitus (T2DM) patients.Summary Background Data: Little is known about the long-term change in metabolic and lipid profiles of T2DM patients after RYGBP.Methods: This is a retrospective review of prospectively collected data about glucose metabolism and lipid profiles of morbidly obese patients with T2DM on antidiabetic medications who underwent laparoscopic RYGBP.Results: A total 219 patients with mean (+/- SD) duration of follow-up of 26.4 (+/- 12.8) months were included in the study. At one year postoperative mean serum fasting plasma glucose fell from 152.8 to 106.0 mg/dL, HGBA1c (glycated hemoglobin) fell from 7.6% to 6.1%, TC (total cholesterol) went from 180.9 to 172.0 mg/dL, TG (triglyceride) fell from 208.0 to 117.4 mg/dL, and HDL-C (HDL-cholesterol) levels increased from 48.7 to 58.7 mg/dL. These improvements were maintained 2 to 4 years after surgery. Older age, longer duration of T2DM, and insulin use were important preoperative factors associated with failure to resolve T2DM. Postoperatively, the amount of total weight loss was associated with the improvement or resolution of T2DM (P = 0.053).Conclusion: Laparoscopic RYGBP has a beneficial effect on glucose metabolism and serum lipid composition in obese T2DM patients. Sustained weight loss was associated with maintenance of euglycemia in postoperative obese T2DM patients.