Health-Related Quality of Life and Health Utility After Metabolic/Bariatric Surgery Versus Medical/Lifestyle Intervention in Individuals With Type 2 Diabetes and Obesity: The ARMMS-T2D Study

被引：0

作者：

Simonson, Donald C. ^{[1
,2
]}

Gourash, William F. ^{[3
]}

Arterburn, David E. ^{[4
]}

Hu, Bo ^{[5
]}

Kashyap, Sangeeta R. ^{[5
,6
]}

Cummings, David E. ^{[7
]}

Patti, Mary-Elizabeth ^{[2
,8
]}

Courcoulas, Anita P. ^{[3
]}

Vernon, Ashley H. ^{[1
,2
]}

Jakicic, John M. ^{[3
,9
]}

Kirschling, Sarah ^{[5
]}

Aminian, Ali ^{[5
]}

Schauer, Philip R. ^{[5
,10
]}

Kirwan, John P. ^{[5
,10
]}

机构：

[1] Brigham & Womens Hosp, Boston, MA 02115 USA

[2] Harvard Med Sch, Boston, MA 02115 USA

[3] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA

[4] Kaiser Permanente Washington Hlth Res Inst, Seattle, WA USA

[5] Cleveland Clin, Cleveland, OH USA

[6] Weill Cornell Med, New York, NY USA

[7] Univ Washington, Med Sch, Seattle, WA USA

[8] Joslin Diabet Ctr, Boston, MA USA

[9] Univ Kansas, Med Ctr, Kansas City, KS USA

[10] Pennington Biomed Res Ctr, Baton Rouge, LA USA

来源：

DIABETES CARE | 2025年 / 48卷 / 04期

关键词：

GASTRIC BYPASS-SURGERY; BARIATRIC SURGERY; MEDICAL THERAPY; STYLE INTERVENTION; METABOLIC SURGERY; SURVEY SF-36; WEIGHT-LOSS; FOLLOW-UP; OUTCOMES; SF-6D;

D O I：

10.2337/dc24-2046

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE. Type 2 diabetes and obesity are associated with reduced health-related quality of life (HRQoL) and health utility (HU), but long-term effects of metabolic/bariatric surgery (MBS) compared with those of medical/lifestyle intervention (MLI) on these outcomes are unclear. RESEARCH DESIGN AND METHODS. We studied 228 individuals with type 2 diabetes and obesity randomly assigned to MBS (Roux-en-Y gastric bypass, sleeve gastrectomy, or gastric band; n = 152) or MLI (n = 76) in the ARMMS-T2D study. HRQoL (36-Item Short-Form Health Survey [SF-36], including Physical Component Score [PCS] and Mental Component Score [MCS]) and HU (Short Form 6 Dimensions [SF-6D]) were measured annually up to 12 years. RESULTS. At baseline, participants' mean +/- SD age was 49.2 +/- 8.0 years, 68.4% were female, BMI was 36.3 +/- 3.4 kg/m(2), and HbA1c was 8.7 +/- 1.6%. PCS improved significantly more in the MBS versus MLI group over 12 years (+2.37 +/- 0.53 vs. -0.95 +/- 0.73; difference 3.32 +/- 0.85; P < 0.001). MBS was associated with better general health (P < 0.001), physical functioning (P = 0.001), and vitality (P = 0.003). Reduction in BMI was greater after MBS versus MLI (P < 0.001) and correlated with improved PCS (r = -0.43; P < 0.001). Change in PCS was not associated with change in HbA1c. MCS changed minimally from baseline and was similar between MBS and MLI groups during follow-up (-0.21 +/- 0.61 vs. -0.89 +/- 0.84; difference 0.68 +/- 0.97; P = 0.48). Improvements in HU were greater in the MBS versus MLI group over 12 years (+0.02 +/- 0.01 vs. -0.01 +/- 0.01; difference 0.03 +/- 0.01; P = 0.003). CONCLUSIONS. Metabolic surgery produces sustained weight loss and improves PCS, general health, physical functioning, vitality, and HU in individuals with type 2 diabetes and obesity compared with medical therapy up to 12 years after intervention.

引用

页码：537 / 545

页数：10

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