Predictors of diabetes remission after bariatric surgery in Asia
Predictors of diabetes remission after bariatric surgery in Asia
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DOI：
10.1016/j.asjsur.2012.04.010
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发表时间：
2012-04-01
影响因子：
3.5
通讯作者：
Chen, Shu-Chun
中科院分区：
文献类型：
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作者：
Lee, Wei-Jei;Chong, Keong;Chen, Shu-Chun
背景：肥胖与2型糖尿病（T2 DM）关系密切，目前的药物治疗难以控制。已提出减肥手术治疗与肥胖相关的控制不佳的T2 DM。然而，尚未在亚洲患者中明确研究T2 DM术后成功缓解的预测。本研究为胃肠外科作为代谢外科治疗2型糖尿病提供了参考。从2002年1月至2008年12月，纳入了88例连续的病态肥胖患者，这些患者入组了手术监督下的减肥计划，并且在手术前患有T2 DM，具有至少1年的完整随访数据。68例（77.2%）患者接受胃旁路手术，其余20例（22.8%）接受限制性手术。我们分析了现有的信息，在初步评估的患者谁被称为减肥手术，通过logistic回归分析和数据挖掘方法成功的糖尿病缓解后surgery.Results的预测因素：总体而言，68（77.2%）的88例T2 DM缓解手术后1年。旁路组患者的缓解率高于限制组[59/68（86.7%）vs. 9/20（45.0%），p = 0.000]。在单变量分析中，与未缓解的患者相比，术后T2 DM缓解的患者更年轻、更重、腰围更宽、疾病不严重、病程更短、C肽水平更高。多变量逻辑回归分析后，手术类型和T2 DM持续时间仍然是成功的独立预测因素（p < 0.000）。数据挖掘分析证实，T2 DM的持续时间是最重要的predictor.Conclusions：减肥手术是T2 DM的治疗选择。糖尿病的持续时间是手术成功的最佳预测因素。版权所有（C）2012，亚洲外科协会。出版社：Elsevier Taiwan LLC All rights reserved.
Background: Obesity and type II diabetes mellitus (T2DM) are closely related and difficult to control by current medical treatment. Bariatric surgery has been proposed for inadequately controlled T2DM in association with obesity. However, prediction of successful T2DM remission after surgery has not been clearly studied in Asian patients. This information might be helpful for applying gastrointestinal surgery as metabolic surgery for T2DM.Methods: This was a retrospective clinical study. From January 2002 to December 2008, 88 consecutive patients with morbid obesity, who were enrolled into a surgically supervised weight loss program, and who had T2DM before surgery with at least 1 year complete follow-up data were included. Sixty-eight (77.2%) patients received gastric bypass procedures, and the remaining 20 (22.8%) received restrictive procedures. We analyzed the available information during the initial evaluation of patients who were referred for bariatric surgery, by logistic regression analysis and data mining methods for predictors of successful diabetes remission after surgery.Results: Overall, 68 (77.2%) of the 88 patients had remission of their T2DM 1 year after surgery. Patients in the bypass group had a higher remission rate than those in the restrictive group [59/68 (86.7%) vs. 9/20 (45.0%), p = 0.000]. In univariate analysis, patients who had T2DM remission after surgery were younger, heavier, had a wider waist, less severe disease, shorter duration, and higher C-peptide levels than those without remission. Type of operation and T2DM duration remained independent predictors of success after multivariate logistical regression analysis (p < 0.000). Data mining analysis confirmed that T2DM duration was the most important predictor.Conclusions: Bariatric surgery is a treatment option for T2DM. Duration of diabetes is the most predictor of success after surgery. Copyright (C) 2012, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.