Type 2 diabetes remission 2 years post Roux-en-Y gastric bypass and sleeve gastrectomy: the role of the weight loss and comparison of DiaRem and DiaBetter scores.
Type 2 diabetes remission 2 years post Roux-en-Y gastric bypass and sleeve gastrectomy: the role of the weight loss and comparison of DiaRem and DiaBetter scores.
复制标题
DOI：
10.1111/dme.13532
复制
发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Batterham RL
中科院分区：
文献类型：
--
作者：
Pucci A;Tymoszuk U;Cheung WH;Makaronidis JM;Scholes S;Tharakan G;Elkalaawy M;Guimaraes M;Nora M;Hashemi M;Jenkinson A;Adamo M;Monteiro MP;Finer N;Batterham RL
The comparative efficacy of Roux‐en‐Y gastric bypass (RYGB) and sleeve gastrectomy on Type 2 diabetes remission and the role of weight loss are unclear. The DiaRem diabetes remission prediction score uses HbA1c, age and diabetes medications but not diabetes duration. The aim of this study was to compare the DiaRem with the DiaBetter score that includes diabetes duration, upon combined (complete plus partial) 2‐year post‐surgery diabetes remission in people following RYGB and sleeve gastrectomy, and to investigate the relationship between weight loss and diabetes remission. A retrospective single‐centre cohort study of obese people with diabetes who underwent RYGB (107) or sleeve gastrectomy (103) and a validation cohort study (173) were undertaken. Diabetes remission, % weight loss, DiaRem, DiaBetter scores and areas under receiving operator characteristic (ROC) curves were calculated. The relationship between % weight loss and diabetes remission was investigated using logistic regression. The proportion of people achieving diabetes remission was highest for those with the lowest DiaBetter and DiaRem scores. Areas under the ROC curves were comparable [DiaBetter: 0.867 (95%CI: 0.817–0.916); DiaRem: 0.865 (95%CI: 0.814–0.915), P=0.856]. Two‐year % weight loss was higher post RYGB [26.6 (95%CI: 24.8–28.4)] vs post‐sleeve gastrectomy [20.6 (95%CI: 18.3–22.8), P<0.001]. RYGB had 151% higher odds of diabetes remission [OR 2.51 (95%CI: 1.12–5.60), P=0.025]. This association became non‐significant when adjusted for % weight loss. DiaBetter and DiaRem scores predict diabetes remission following both procedures. Two‐year % weight loss plays a key role in determining diabetes remission. Roux‐en‐Y gastric bypass (RYGB) and sleeve gastrectomy can lead to Type 2 diabetes remission in people with obesity and Type 2 diabetes. The impact of post‐surgery weight loss and surgical procedure type upon Type 2 diabetes remission rates are unclear. The DiaRem score predicts post‐RYGB Type 2 diabetes remission but does not include Type 2 diabetes duration, which negatively associates with Type 2 diabetes remission rates. We show that the novel DiaBetter Score, which includes Type 2 diabetes duration, predicts Type 2 diabetes remission at 2 years following RYBG and sleeve gastrectomy with comparable predictive power to DiaRem. Importantly, we show that percentage weight loss rather than procedure type determines Type 2 diabetes remission 2 years postoperatively.
登录
查看更多内容
DOI：
10.1056/nejmoa1401329
发表时间：
2014-05-22
期刊：
The New England journal of medicine
影响因子：
--
作者：
Schauer PR;Bhatt DL;Kirwan JP;Wolski K;Brethauer SA;Navaneethan SD;Aminian A;Pothier CE;Kim ES;Nissen SE;Kashyap SR;STAMPEDE Investigators
通讯作者：
STAMPEDE Investigators
影响因子：
3.5
作者：
Steven, S.;Carey, P. E.;Taylor, R.
通讯作者：
Taylor, R.
影响因子：
--
作者：
Manning, Sean;Carter, Nicholas C;Batterham, Rachel L
通讯作者：
Batterham, Rachel L
影响因子：
9
作者：
Peterli R;Borbély Y;Kern B;Gass M;Peters T;Thurnheer M;Schultes B;Laederach K;Bueter M;Schiesser M
通讯作者：
Schiesser M
腹腔镜套筒胃切除术和腹腔镜胃搭桥对食欲，循环酰基 - ghrelin，肽YY3-36和活性GLP-1水平的差异作用。
影响因子：
2.9
作者：
Yousseif, Ahmed;Emmanuel, Julian;Karra, Efthimia;Millet, Queensta;Elkalaawy, Mohamed;Jenkinson, Andrew D.;Hashemi, Majid;Adamo, Marco;Finer, Nicholas;Fiennes, Alberic G.;Withers, Dominic J.;Batterham, Rachel L.
通讯作者：
Batterham, Rachel L.