Risk of post-gastric bypass surgery hypoglycemia in nondiabetic individuals: A single center experience.
Risk of post-gastric bypass surgery hypoglycemia in nondiabetic individuals: A single center experience.
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DOI：
10.1002/oby.21479
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发表时间：
2016-06
期刊：
影响因子：
--
通讯作者：
Benotti P
中科院分区：
文献类型：
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作者：
Lee CJ;Wood GC;Lazo M;Brown TT;Clark JM;Still C;Benotti P
胃旁路手术后低血糖（PGBH）的流行病学还不完全清楚。本研究旨在评估非糖尿病患者PGBH的风险及其相关因素。对接受Roux-en-Y胃旁路术（RYGB）的非糖尿病患者进行了队列研究。PGBH定义为术后血糖< 60 mg/dL、诊断为低血糖或使用任何药物治疗PGBH。Kaplan-Meier分析用于描述PGBH发生率，对数秩检验和考克斯回归用于检查相关因素。在1，206例合格患者中，86%为女性，平均年龄为43.7岁，平均术前BMI为48.7 kg/m2，平均随访时间为4.8年。RYGB后1年和5年低血糖的累积发生率分别为2.7%和13.3%。在158例患者中确定了PGBH的发生率，并与术前BMI较低（P = 0.048）、术前HbA 1c较低（P = 0.012）和6个月过度体重减轻百分比（%EWL）较高（P = 0.001）相关。在多元回归分析中，术前HbA 1c较低（HR = 1.73，P = 0.0034）和6个月EWL %较高（HR = 1.96，P = 0.0074）仍与PGBH风险增加独立相关。非糖尿病患者PGBH的5年发生率为13.3%，与术前HbA 1c较低和术后6个月体重减轻较大相关。
The epidemiology of post-gastric bypass surgery hypoglycemia (PGBH) is incompletely understood. This study aimed to evaluate the risk of PGBH among nondiabetic patients and associated factors. A cohort study of nondiabetic patients who underwent Roux-en-Y gastric bypass (RYGB) was conducted. PGBH was defined by any postoperative record of glucose < 60 mg/dL, diagnosis of hypoglycemia, or any medication use for treatment of PGBH. Kaplan-Meier analysis was used to describe PGBH occurrence, log-rank tests, and Cox regression to examine associated factors. Of the 1,206 eligible patients, 86% were female with mean age of 43.7 years, mean preoperative BMI of 48.7 kg/m2, and a mean follow-up of 4.8 years. The cumulative incidence of hypoglycemia at 1 and 5 years post-RYGB was 2.7% and 13.3%, respectively. Incidence of PGBH was identified in 158 patients and was associated with lower preoperative BMI (P = 0.048), lower preoperative HbA1c (P = 0.012), and higher 6-month percent of excess body weight loss (%EWL) (P = 0.001). A lower preoperative HbA1c (HR = 1.73, P = 0.0034) and higher 6-month %EWL (HR = 1.96, P = 0.0074) remained independently correlated with increased risk for PGBH in multi-regression analysis. The 5-year incidence of PGBH among nondiabetic individuals was 13.3% and was associated with a lower preoperative HbA1c and greater weight loss at 6 months following surgery.