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Ann Intern Med：减肥手术与常规治疗后糖尿病患者的微血管结局

2018-08-13 xing.T MedSci原创

减肥手术常规治疗糖尿病患者微血管结局
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由此可见，在这项针对T2DM成人的大型多中心研究中，与常规治疗相比，减肥手术与较低的微血管疾病的总体发病率（包括较低的神经病变、肾病和视网膜病变）相关。

减肥手术可改善2型糖尿病（T2DM）患者的血糖控制，但对微血管结局的了解较少。近日，内科学权威杂志Annals of Internal Medicine上发表了一篇研究文章，研究人员旨在探讨减肥手术与T2DM患者微血管并发症的关系。

研究人员在2005年至2011年期间进行了一项回顾性匹配队列研究，随访至2015年9月。该研究的参与者为年龄为19至79岁的减肥手术患者（n=4024），并匹配了年龄、性别、体重指数、血红蛋白A1c水平、胰岛素使用、糖尿病病程以及医疗保健强度的3名非手术参与者（n=11059）。研究人员将减肥手术（76％胃旁路手术、17％袖套胃切除术和7％可调节胃束带）组与常规治疗组进行比较。调整后的Cox回归分析调查了发生微血管疾病的时间，定义为首次发生糖尿病视网膜病变、神经病变或肾病。

手术和非手术患者的中位随访时间为4.3年。减重手术与5年时发生微血管病变的风险显著降低有关（手术组为16.9％，非手术组为34.7％;校正风险比[HR]为0.41 [95％CI，0.34-0.48]）。减重手术与较低的5年糖尿病神经病变（手术组为7.2％，非手术组为21.4％; HR为0.37 [95%CI，0.30~0.47]）、肾病（手术组为4.9％，非手术组为10.0％; HR为0.41 [95%CI，0.29~0.58]）和视网膜病变（手术组为7.2％，非手术组为11.2％; HR为0.55 [95%CI，0.42~0.73]）累积发生率有关。

由此可见，在这项针对T2DM成人的大型多中心研究中，与常规治疗相比，减肥手术与较低的微血管疾病的总体发病率（包括较低的神经病变、肾病和视网膜病变）相关。

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原始出处：

Rebecca O'Brien,et al. Microvascular Outcomes in Patients With Diabetes After Bariatric Surgery Versus Usual Care: A Matched Cohort Study. Ann Intern Med 2018. http://annals.org/aim/article-abstract/2696493/microvascular-outcomes-patients-diabetes-after-bariatric-surgery-versus-usual-care

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    2018-11-03 晓辰

    #常规治疗#

    0

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    2018-08-15 mgqwxj

    #微血管#

    0

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    2018-08-15 xue8604

    #糖尿病患者#

    0

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    2018-08-15 ms3994565386320060

    #Med#

    0

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    2018-08-13 惠映实验室

    学习了，谢谢分享。

    0

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    2018-08-13 misszhang

    谢谢MedSci提供最新的资讯

    0

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    2018-08-13 CHANGE

    什么时候有懒人用的减肥神药？

    0

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    2018-08-13 lietome15

    认真学习，把间接经验应用到临床实践中去，然后再总结出新思路。给点赞啦

    0

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