Diabetes Care:对于糖尿病患者,哪种减肥手术更好?

2016-11-10 MedSci MedSci原创

血糖控制方面,Roux-en-Y胃旁路术(RYGB)的效果优于腹腔镜可调节胃束带术(LAGB),不过RYGB术后更大的体重下降程度让比较结果混淆。因此,我们研究了这两种手术(RYGB和LAGB)对代谢参数的影响,匹配小量和大量的体重下降。 对严重肥胖的2型糖尿病患者,在术前、术后1年,口服给药和静脉注射葡萄糖刺激后,检测葡萄糖代谢、β细胞功能,同时在术后体重下降10%和20%时,进行这些检测

血糖控制方面,Roux-en-Y胃旁路术(RYGB)的效果优于腹腔镜可调节胃束带术(LAGB),不过RYGB术后更大的体重下降程度让比较结果混淆。因此,我们研究了这两种手术(RYGB和LAGB)对代谢参数的影响,匹配小量和大量的体重下降。

对严重肥胖的2型糖尿病患者,在术前、术后1年,口服给药和静脉注射葡萄糖刺激后,检测葡萄糖代谢、β细胞功能,同时在术后体重下降10%和20%时,进行这些检测。

与LAGB比较,任何程度的体重下降组,RYGB导致更大的胰高血糖素样肽1释放和肠促胰岛素作用。10%体重下降组,与LAGB比较,RYGB降低血糖水平的程度更高。不过20%体重下降组种,两种手术后患者的糖代谢改善、糖尿病缓解率和使用糖尿病药物、胰岛素敏感性、β细胞功能等都相似。

虽然RYGB保留其肠促胰岛素的独特作用,与LAGB比较,其对葡萄糖代谢的优越性仅限于10%体重下降组,如果体重下降幅度更多,这种优势会衰减。

原始出处:


Marlena M. Holter,et al.Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect.Diabetes Care 2016 Nov

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