Metabolic Syndrome After Roux-en-Y Gastric Bypass Surgery in Chinese Obese Patients with Type 2 Diabetes

被引:20
作者
Yu, Haoyong [1 ]
Zhang, Lei [1 ]
Bao, Yuqian [1 ]
Zhang, Pin [2 ]
Tu, Yinfang [1 ]
Di, Jianzhong [2 ]
Han, Xiaodong [2 ]
Han, Junfeng [1 ]
Jia, Weiping [1 ]
机构
[1] Shanghai Jiao Tong Univ, Dept Endocrinol & Metab,Affiliated Peoples Hosp 6, Shanghai Key Lab Diabet Mellitus,Shanghai Key Cli, Dept Endocrinol & Metab,Shanghai Diabet Inst,Shan, Shanghai 200233, Peoples R China
[2] Shanghai Jiao Tong Univ, Dept Gen Surg, Affiliated Peoples Hosp 6, Shanghai 200233, Peoples R China
基金
中国国家自然科学基金;
关键词
Bariatric surgery; Roux-en-Y gastric bypass; Metabolic syndrome; Obesity; Diabetes; Weight loss; LAPAROSCOPIC SLEEVE GASTRECTOMY; VISCERAL FAT AREA; BARIATRIC SURGERY; WEIGHT-LOSS; CARDIOVASCULAR-DISEASE; PREVALENCE; POPULATION; REMISSION; ADULTS; RISK;
D O I
10.1007/s11695-016-2074-7
中图分类号
R61 [外科手术学];
学科分类号
摘要
Roux-en-Y gastric bypass (RYGB) surgery is currently the most effective treatment for substantial and sustained weight loss in morbidly obese individuals. We aim to determine the prevalence in Chinese obese patients with type 2 diabetes (T2DM) and the efficacy of surgical treatment of the metabolic syndrome (MetS) and its components with a control group in medical therapy. A total of 121 obese T2DM individuals who underwent RYGB and 93 nonoperative obese patients with T2DM were enrolled in the study. MetS was defined according to the criteria established by the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG). We determined the change in MetS and the prevalence of its components and performed logistic regression models to evaluate predictors of MetS remission. One year after RYGB, all MetS components improved in the RYGB group and medication use decreased. Of the RYGB group, MetS prevalence decreased from 108 patients (83.3 %) to 20 (16.5 %), and from 88 patients (94.6 %) to 76 (81.7 %) in the control group. Multiple logistic regression analyses indicated that a shorter diabetes duration and higher percent excess weight loss (%EWL) were associated with a greater chance of MetS remission after surgery. RYGB induces considerable and persistent improvement in MetS prevalence in Chinese obese patients with T2DM. Diabetes duration and %EWL might act as potential prognostic markers in predicting the MetS reversibility.
引用
收藏
页码:2190 / 2197
页数:8
相关论文
共 39 条
[1]   Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity [J].
Alberti, K. G. M. M. ;
Eckel, Robert H. ;
Grundy, Scott M. ;
Zimmet, Paul Z. ;
Cleeman, James I. ;
Donato, Karen A. ;
Fruchart, Jean-Charles ;
James, W. Philip T. ;
Loria, Catherine M. ;
Smith, Sidney C., Jr. .
CIRCULATION, 2009, 120 (16) :1640-1645
[2]   Visceral adipose tissue as a source of inflammation and promoter of atherosclerosis [J].
Alexopoulos, Nikolaos ;
Katritsis, Demosthenes ;
Raggi, Paolo .
ATHEROSCLEROSIS, 2014, 233 (01) :104-112
[3]   Bariatric Surgery Worldwide 2013 [J].
Angrisani, L. ;
Santonicola, A. ;
Iovino, P. ;
Formisano, G. ;
Buchwald, H. ;
Scopinaro, N. .
OBESITY SURGERY, 2015, 25 (10) :1822-1832
[4]  
[Anonymous], 2014, CHIN J ENDOCRINOL ME
[5]  
[Anonymous], 2007, Zhonghua Xin Xue Guan Bing Za Zhi
[6]  
Batsis JA, 2008, MAYO CLIN PROC, V83, P897, DOI 10.4065/83.8.897
[7]   Bariatric surgery: A systematic review and meta-analysis [J].
Buchwald, H ;
Avidor, Y ;
Braunwald, E ;
Jensen, MD ;
Pories, W ;
Fahrbach, K ;
Schoelles, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (14) :1724-1737
[8]   Weight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis [J].
Buchwald, Henry ;
Estok, Rhonda ;
Fahrbach, Kyle ;
Banel, Deirdre ;
Jensen, Michael D. ;
Pories, Walter J. ;
Bantle, John P. ;
Sledge, Isabella .
AMERICAN JOURNAL OF MEDICINE, 2009, 122 (03) :248-U81
[9]   Impact of weight loss on the metabolic syndrome [J].
Case, CC ;
Jones, PH ;
Nelson, K ;
Smith, EO ;
Ballantyne, CM .
DIABETES OBESITY & METABOLISM, 2002, 4 (06) :407-414
[10]   Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) [J].
Cleeman, JI ;
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, DR ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19) :2486-2497