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Diabetes Obes Metab：代谢手术治疗2型糖尿病的疗效分析

2020-04-05 MedSci原创 MedSci原创

2型糖尿病疗效代谢手术
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MS是治疗T2D的一个有趣的选择，尽管需要进一步的数据来证明它的长期有效性和安全性。目前的数据不足以支撑对目前的指南建议的修改，其认为MS可能是治疗BMI大于35 kg/m2的T2D患者的一种手段。

近日，代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章，这项网络meta分析(NMA)的目的是比较不同类型的代谢手术(MS)和药物治疗(MT)治疗2型糖尿病(T2D)的疗效。

该NMA纳入了比较T2D患者采用不同MS类型与MT的随机临床试验，这些研究持续时间≥24周。该分析的主要终点为糖化血红蛋白(HbA1c)、空腹血糖(FPG)和糖尿病缓解情况。NMA对不同类型的手术进行了间接比较。研究人员使用随机效应模型计算连续变量的均值和95%置信区间，以及分类变量的Mantel‐Haenzel比值比[MH‐OR]。MS类型包括腹腔镜可调控性胃束带术(LABG)、Roux‐en‐Y胃旁通道(RYGB)、袖状胃切除术(SG)和胆胰分流术(BPD)、胃大弯折叠术(GCP)、单吻合口胃旁路吻合术(OAGB)、十二指肠—空肠旁路术(DJB)。

研究人员共检索到24项试验，包括1351名患者(1017例手术患者和337例MT患者)。受试者平均基线BMI为36.8kg/m2。与MT相比，MS可显著降低受试者HbA1c、FPG，使糖尿病缓解。在NMA中，OAGB和SG可显著降低HbA1c水平。除GCP和LAGB外，所有的手术治疗均可显著增加糖尿病的缓解比例。所有的手术类型都与BMI的降低有关。

由此可见，MS是治疗T2D的一个有趣的选择，尽管需要进一步的数据来证明它的长期有效性和安全性。目前的数据不足以支撑对目前的指南建议的修改，其认为MS可能是治疗BMI大于35 kg/m2的T2D患者的一种手段。

原始出处：

Barbara Cresci,et al.Metabolic Surgery for the Treatment of Type 2 Diabetes: A Network Metanalysis of Randomized Controlled Trials.Diabetes Obesity & Metabolism.2020.https://doi.org/10.1111/dom.14045

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    2021-02-12 木头人513

    #Diabetes#

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    2020-10-01 rebeccajiejie

    #疗效分析#

    0

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15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2021-03-02 贵阳

    #代谢手术#

    0

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style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun May 10 05:51:02 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888126, encodeId=5c471888126fe, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, 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15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2020-05-29 ms5439512287675881

    #BET#

    0

  5. 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style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun May 10 05:51:02 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888126, encodeId=5c471888126fe, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, 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15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2020-08-26 ms9608593228839890

    #DIA#

    0

  6. 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style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun May 10 05:51:02 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888126, encodeId=5c471888126fe, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, 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15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2020-05-10 一闲

    #MET#

    0

  7. 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15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2021-01-26 仁心济世

    #Meta#

    0

  8. 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style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun May 10 05:51:02 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888126, encodeId=5c471888126fe, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Tue Jan 26 01:51:02 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290738, encodeId=6d0a1290e3834, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Tue Apr 07 03:51:02 CST 2020, time=2020-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032461, encodeId=f0c31032461cf, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2020-04-07 lixiaol

    #手术治疗#

    0

  9. 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15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2020-04-05 内科新手

    谢谢梅斯提供这么好的信息，学到很多

    0

  10. 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style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sun May 10 05:51:02 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888126, encodeId=5c471888126fe, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, 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15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043045, encodeId=9de210430454b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Apr 05 15:51:02 CST 2020, time=2020-04-05, status=1, ipAttribution=)]
    2020-04-05 misszhang

    谢谢MedSci提供最新的资讯

    0

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