The Effects of Bariatric Surgery on Renal, Neurological, and Ophthalmic Complications in Patients with Type 2 Diabetes: the Taiwan Diabesity Study

被引：14

作者：

Chang, Yi-Cheng ^{[1
,2
,3
]}

Chao, Seh-Huang ^{[4
]}

Chen, Ching-Chu ^{[5
,6
]}

Ser, Kong-Han ^{[7
]}

Chong, Keong ^{[8
]}

Lu, Chieh-Hsiang ^{[9
]}

Hsieh, Meng-Lun ^{[1
,2
]}

Huang, Yu-Yao ^{[10
]}

Lee, Yi-Chih ^{[11
]}

Hsu, Chih-Cheng ^{[12
]}

Chuang, Lee-Ming ^{[1
,13
]}

Lee, Wei-Jei ^{[14
,15
]}

机构：

[1] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan

[2] Natl Taiwan Univ, Grad Inst Med Genom & Prote, Taipei, Taiwan

[3] Acad Sinica, Inst Biomed Sci, Taipei, Taiwan

[4] Jen Ai Hosp, Div Gen Surg, Taichung, Taiwan

[5] China Med Univ Hosp, Div Endocrinol & Metab, Dept Med, Taichung, Taiwan

[6] China Med Univ, Sch Chinese Med, Taichung, Taiwan

[7] Ten Chen Gen Hosp, Dept Surg, Taoyuan, Taiwan

[8] Min Sheng Gen Hosp, Dept Med, Taoyuan, Taiwan

[9] Chia Yi Christian Hosp, Div Endocrinol & Metab, Chiayi, Taiwan

[10] Chang Gung Mem Hosp, Div Endocrinol & Metab, Taoyuan, Taiwan

[11] Chien Hsin Univ Sci & Technol, Dept Int Business, Taoyuan, Taiwan

[12] Natl Hlth Res Inst, Inst Populat Hlth Sci, Zhunan, Taiwan

[13] Natl Taiwan Univ, Grad Inst Mol Med, Taipei, Taiwan

[14] Min Sheng Gen Hosp, Div Gen Surg, Taoyuan, Taiwan

[15] Natl Taiwan Univ Hosp, Dept Surg, Taipei, Taiwan

来源：

OBESITY SURGERY | 2021年 / 31卷 / 01期

关键词：

Bariatric surgery; Diabetic neuropathy; Diabetic nephropathy; Diabetic opthalmopathy; INTENSIVE MEDICAL-MANAGEMENT; OBESE-PATIENTS; NEUROPATHY; RETINOPATHY; ASSOCIATION; IMPROVEMENT; THERAPY;

D O I：

10.1007/s11695-020-04859-9

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background Bariatric surgery has been shown to improve glycemic control in patients with type 2 diabetes. However, less is known whether it can also reduce diabetic renal, neurological, and ophthalmic complications. Methods This prospective multicenter cohort study compared renal, ophthalmic, and neurological complications between 49 patients with obesity/overweight receiving bariatric surgery and 338 patients receiving standard medical treatment after follow-up for 2 years. Patients received neurological examinations including toe tuning fork vibration test, ankle tendon reflex test, 10-g monofilament test, and ophthalmic examinations including visual acuity measurement and fundus examinations. Multiple regressions, propensity score weighting, and matching were employed to adjust for baseline differences. Results After 2 years of follow-up, patients with type 2 diabetes receiving bariatric surgery had greater reduction in BMI, HbA1c, and urine albumin-creatinine ratio, greater improvement in estimated glomerular filtration rate, and greater increase in tuning fork test score of right and left toes compared with the medical group. However, there is no improvement in 10 g-monofilament test, visual acuity, diabetic non-proliferative retinopathy, and proliferative retinopathy. Similar results were obtained using multiple regression adjustment, propensity-score weighting, or comparing age-, sex-, and BMI-matched subjects. Conclusions After 2-year follow-up, patients with obesity/overweight and type 2 diabetes receiving bariatric surgery have increased glomerular filtration rate, reduced albuminuria, and improved tuning folk vibration sensation.

引用

页码：117 / 126

页数：10

共 36 条

[1] The Effects of Bariatric Surgery on Renal Outcomes: a Systematic Review and Meta-analysis [J].