Gastric Bypass Surgery Leads to Long-term Remission or Improvement of Type 2 Diabetes and Significant Decrease of Microvascular and Macrovascular Complications
Gastric Bypass Surgery Leads to Long-term Remission or Improvement of Type 2 Diabetes and Significant Decrease of Microvascular and Macrovascular Complications
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DOI：
10.1097/sla.0000000000001509
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发表时间：
2016-06-01
影响因子：
9
通讯作者：
Torquati, Alfonso
中科院分区：
文献类型：
--
作者：
Chen, Yijun;Corsino, Leonor;Torquati, Alfonso
目的：本研究的目的是比较2组Roux-en-Y胃旁路手术治疗的2型糖尿病1型病态肥胖患者和一组类似的药物治疗患者的长期结局。在2000年1月至2004年7月期间接受胃旁路手术的173例肥胖2型糖尿病患者中，78例患者（45%）至少随访10年。对照组由80名来自同一时期的糖尿病肥胖患者组成，这些患者具有相似的体重指数、年龄、种族和糖尿病严重程度。两组的中位随访时间均为11年。结果：接受胃旁路手术的组比对照组有更大的过度减肥百分比，分别为-66%和-1.6%。手术组糖尿病完全缓解41例（52.6%），部分缓解5例（6.4%）。12例（15.4%）患者在初始缓解后糖尿病复发。对照组无糖尿病缓解。与对照组相比，胃旁路手术组的微血管并发症发生率明显降低-分别为46.3%和11.5%，大血管并发症发生率分别为20.3%和5%（P
Objectives: The aim of the study was to compare long-term outcomes of 2 groups of morbidly obese patientswith type 2 diabetes mellitus-1 managed by Roux-en-Y gastric bypass surgery and a comparable group managed medically.Methods: The present study was a single-institution retrospective study. Of the 173 obese patients with type 2 diabetes mellitus undergoing gastric bypass surgery between January 2000 and July 2004, 78 patients (45%) were followed for at least 10 years. The control group consisted of 80 diabetic obese patients from the same period with similar body mass index, age, race, and severity of diabetes. The median follow-up was 11 years for both the groups.Results: The group undergoing gastric bypass surgery had greater percentage of excess weight loss than the control group -66% versus -1.6%, respectively. Forty-one patients (52.6%) in the surgery group had complete remission of diabetes and 5 (6.4%) had partial remission. Twelve patients (15.4%) had diabetes recurrence after initial remission. No patient in the control group had remission of diabetes. Compared with the control group, the group undergoing gastric bypass surgery had a significantly reduced incidence of microvascular complications-46.3% versus 11.5%, and macrovascular complication-20.3% versus 5%, respectively (P