JAMA Surg:减肥手术对II型糖尿病患者临床改善作用

2020-03-09 MedSci原创 MedSci原创

Roux-en-Y胃旁路术在改善肥胖糖尿病患者症状方面的效果优于袖状胃切除术

减肥手术可使得II型糖尿病(T2DM)患者发生实质性改善,近日研究人员评估了手术方式与T2DM患者预后的关系。

研究在美国34个医疗中心开展,T2DM成人患者随机接受Roux-en-Y胃旁路术(RYGB)或袖状胃切除术(SG)。研究的主要终点为T2DM缓解、复发、总体重下降百分比以及糖化血红蛋白(血红蛋白A1c)的变化。

9710名患者参与研究,平均随访2.7年,女性占72.6%,患者平均年龄49.8岁,平均BMI 49.0。在1年(平均差异6.3%)和5年(平均差异8.1%)随访时,RYGB组的体重减轻程度显著大于SG组。术后1年,接受RYGB和SG治疗的患者经调整后的累积T2DM缓解率分别为59.2%和55.9%,术后5年分别为86.1%和83.5%。在T2DM缓解的6141例患者中,RYGB患者的T2DM复发率低于SG患者(危险比:0.75)。术后1年,RYGB和SG组的复发率分别为8.4%和11.0%,术后5年后分别为33.1%和41.6%。5年时,与基线相比,RYGB患者的糖化血红蛋白较SG组降低了0.45%。

研究认为,Roux-en-Y胃旁路术在改善肥胖糖尿病患者症状方面的效果优于袖状胃切除术。

原始出处:

Kathleen M. Mc Tigue et al. Comparing the 5-Year Diabetes Outcomes of Sleeve Gastrectomy and Gastric Bypass The National Patient-Centered Clinical Research Network (PCORNet) Bariatric Study.JAMA Surg. March 4, 2020.

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  3. [GetPortalCommentsPageByObjectIdResponse(id=1429726, encodeId=77771429e269c, content=<a href='/topic/show?id=9a8d9592b0' target=_blank style='color:#2F92EE;'>#II型糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9592, encryptionId=9a8d9592b0, topicName=II型糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d7914226234, createdName=lsj629, createdTime=Wed Mar 11 10:37:09 CST 2020, time=2020-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474893, encodeId=1dc314e4893a4, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Wed Mar 11 10:37:09 CST 2020, time=2020-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035954, encodeId=93431035954b5, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043000, encodeId=10ec1043000c7, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048298, encodeId=a8511048298bf, content=什么时候有懒人用的减肥神药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=)]
    2020-03-09 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1429726, encodeId=77771429e269c, content=<a href='/topic/show?id=9a8d9592b0' target=_blank style='color:#2F92EE;'>#II型糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9592, encryptionId=9a8d9592b0, topicName=II型糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d7914226234, createdName=lsj629, createdTime=Wed Mar 11 10:37:09 CST 2020, time=2020-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474893, encodeId=1dc314e4893a4, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Wed Mar 11 10:37:09 CST 2020, time=2020-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035954, encodeId=93431035954b5, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043000, encodeId=10ec1043000c7, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048298, encodeId=a8511048298bf, content=什么时候有懒人用的减肥神药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=)]
    2020-03-09 misszhang

    谢谢MedSci提供最新的资讯

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1429726, encodeId=77771429e269c, content=<a href='/topic/show?id=9a8d9592b0' target=_blank style='color:#2F92EE;'>#II型糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9592, encryptionId=9a8d9592b0, topicName=II型糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d7914226234, createdName=lsj629, createdTime=Wed Mar 11 10:37:09 CST 2020, time=2020-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474893, encodeId=1dc314e4893a4, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Wed Mar 11 10:37:09 CST 2020, time=2020-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035954, encodeId=93431035954b5, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043000, encodeId=10ec1043000c7, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048298, encodeId=a8511048298bf, content=什么时候有懒人用的减肥神药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Mon Mar 09 22:37:09 CST 2020, time=2020-03-09, status=1, ipAttribution=)]
    2020-03-09 CHANGE

    什么时候有懒人用的减肥神药?

    0

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