Diabetes Care:减肥手术对2型糖尿病患者微血管并发症的影响

2020-11-11 MedSci原创 MedSci原创

BS与糖尿病相关的微血管并发症的发生率显著降低有关。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,这项研究旨在评估减肥手术(BS)对2型糖尿病和肥胖症患者的糖尿病相关足病(DFD)、威胁视力的糖尿病性视网膜病(STDR)和慢性肾脏病(CKD)微血管并发症的影响。

研究人员使用IQVIA医学研究数据对1990年1月1日至2018年1月31日期间的2型糖尿病成年人进行的基于人群的回顾性匹配对照研究。研究人员将每个接受BS的2型糖尿病患者(手术组)按年龄、性别、BMI和糖尿病病程匹配最多2名没有接受BS的2型糖尿病患者(非手术组)。

该研究共纳入了1126名手术参与者和2219名非手术参与者。在研究中,女性有2261人(68%)。手术组和非手术组的平均(SD)年龄分别为49.87(9.3)岁和50.12(9.3)岁,BMI分别为46.76(7.96)kg/m2和46.14(7.49)kg/m2。在手术组中,分别有22.1%、22.7%、52.2%和1.1%的患者接受了胃束带、袖胃切除术、Roux-en-Y胃搭桥术(RYGB)和十二指肠术。在3.9年的中位随访时间(四分位数范围1.8-6.4)中,BS与微血管并发症(调整后的风险比为0.53、95%CI为0.43–0.66,P<0.001)、DFD(0.61、0.50-0.75,P<0.001)、STDR(0.66,0.44–1.00,P=0.048)和CKD(0.63,0.51-0.78,P<0.001)的发生率降低相关。基于手术类型的分析表明,所有类型的手术均对复合性微血管并发症的发生产生有利影响,其中RYGB的效应最明显。

由此可见,BS与糖尿病相关的微血管并发症的发生率显著降低有关。
 
原始出处:
 
Pushpa Singh,et al.The Impact of Bariatric Surgery on Incident Microvascular Complications in Patients With Type 2 Diabetes: A Matched Controlled Population-Based Retrospective Cohort Study.Diabetes care.2020.https://doi.org/10.2337/dc20-0571

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    2021-08-06 丁鹏鹏
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  6. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545379, encodeId=421215453e9c4, content=<a href='/topic/show?id=a803896303f' target=_blank style='color:#2F92EE;'>#血管并发症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89630, encryptionId=a803896303f, topicName=血管并发症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b67913724176, createdName=ms3892185887221420, createdTime=Fri Nov 13 14:48:43 CST 2020, time=2020-11-13, status=1, ipAttribution=)]
    2020-12-07 派派 rain

    学习了

    0

  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545379, encodeId=421215453e9c4, content=<a href='/topic/show?id=a803896303f' target=_blank style='color:#2F92EE;'>#血管并发症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89630, encryptionId=a803896303f, topicName=血管并发症)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b67913724176, createdName=ms3892185887221420, createdTime=Fri Nov 13 14:48:43 CST 2020, time=2020-11-13, status=1, ipAttribution=)]
    2020-11-13 mgqwxj
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在T2DM患者中,全身亮氨酸氧化速率的降低支持了该研究的假说,即较高的血浆BCAA水平可能至少部分源自线粒体降低的氧化能力。

JCEM:青少年非酒精性脂肪性肝病与成年后的2型糖尿病风险

在正常血糖的青少年中,NAFLD与2型糖尿病的风险增加相关。

PNAS:胰岛素的折叠瓶颈或使大多数人易患2型糖尿病

科学家发现,胰岛素已经遇到了进化的死胡同,限制了它适应肥胖的能力,从而使大多数人容易患2型糖尿病。

Circulation:SGLT2抑制剂恩格列净也具有利尿作用

SGLT2(钠-葡萄糖同向转运体2)抑制剂可改善2型糖尿病患者心力衰竭相关的预后。在心力衰竭患者中,SGLT2抑制剂可能与袢利尿剂具有协同作用,但这种联合作用尚不明确。该研究(RECEDE-CHF)目