Preserving β-cell function is the major determinant of diabetes remission following laparoscopic sleeve gastrectomy in Japanese obese diabetic patients.
Preserving β-cell function is the major determinant of diabetes remission following laparoscopic sleeve gastrectomy in Japanese obese diabetic patients.
复制标题
保留β细胞功能是日本肥胖糖尿病患者腹腔镜袖状胃切除术后糖尿病缓解的主要决定因素。
DOI：
10.1507/endocrj.ej19-0054
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发表时间：
2019
影响因子：
2
通讯作者：
H. Maegawa
中科院分区：
文献类型：
--
作者：
S. Ugi;K. Morino;Tsuyoshi Yamaguchi;Hiroshi Yamamoto;Sachiko Kaida;I. Miyazawa;Daisuke Sato;Osamu Sekine;Y. Fujita;A. Kashiwagi;M. Tani;H. Maegawa
腹腔镜套管胃切除术已被证明对治疗肥胖相关的2型糖尿病（T2DM）有效。然而，关于腹腔镜袖胃切除术对日本肥胖T2DM患者糖代谢影响的报道很少。本研究的目的是评估腹腔镜下袖式胃切除术对日本肥胖T2DM患者糖耐量的影响，并分析术后糖尿病缓解的影响因素。这是一项对24例连续接受腹腔镜袖式胃切除术的T2DM患者数据的回顾性分析。我们研究了术后1年体重减轻及其对T2DM的影响。我们还比较了糖尿病缓解患者和未缓解患者的基线特征和术后因素。平均体重减轻23.9 kg，总体重减轻23.3%。平均血红蛋白A1c水平从7.3±0.3%降至6.1±0.2%，18例（75%）患者术后1年糖尿病缓解。缓解患者的糖化血红蛋白水平显著降低（p = 0.026），空腹c肽值显著升高（p < 0.001），糖尿病持续时间显著缩短（p < 0.001），胰岛素需要量显著降低（p = 0.002），口服糖耐量试验时胰岛素反应曲线下面积显著升高（p < 0.001），胰岛素原指数显著升高（p < 0.001）。综上所述，腹腔镜袖胃切除术是治疗日本肥胖T2DM患者的有效方法。保持胰岛素分泌是糖尿病缓解的主要决定因素。
Laparoscopic sleeve gastrectomy has been proven effective in treating obesity-associated type 2 diabetes mellitus (T2DM). However, reports of the effect of laparoscopic sleeve gastrectomy on glucose metabolism in Japanese obese patients with T2DM are rare. The aim of this study was to evaluate the effects of laparoscopic sleeve gastrectomy on glucose tolerance in Japanese obese patients with T2DM, and to analyze factors influencing diabetes remission after surgery. This was a retrospective analysis of data for 24 consecutive patients with T2DM who underwent laparoscopic sleeve gastrectomy. We investigated weight loss and its impact on T2DM 1 year postoperatively. We also compared baseline characteristics and postoperative factors between patients who achieved diabetes remission and patients without remission. Mean body weight loss and percent total weight loss were 23.9 kg and 23.3%, respectively. Mean hemoglobin A1c levels dropped from 7.3 ± 0.3% to 6.1 ± 0.2%, and 18 patients (75%) achieved diabetes remission 1 year postoperatively. Patients achieving remission had significantly lower hemoglobin A1c levels (p = 0.026), higher fasting C-peptide values (p < 0.001), shorter diabetes duration (p < 0.001), lower insulin requirement (p = 0.002), and higher area under the insulin response curve (p < 0.001) and insulinogenic index (p < 0.001) during oral glucose tolerance testing. In conclusion, laparoscopic sleeve gastrectomy is an effective treatment for Japanese obese patients with T2DM. Preserving insulin secretion is the major determinant of diabetes remission.
影响因子：
120.7
作者：
Ikramuddin, Sayeed;Korner, Judith;Lee, Wei-Jei;Connett, John E.;Inabnet, William B., III;Billington, Charles J.;Thomas, Avis J.;Leslie, Daniel B.;Chong, Keong;Jeffery, Robert W.;Ahmed, Leaque;Vella, Adrian;Chuang, Lee-Ming;Bessler, Marc;Sarr, Michael G.;Swain, James M.;Laqua, Patricia;Jensen, Michael D.;Bantle, John P.
通讯作者：
Bantle, John P.