Clinical investigation of Roux-en-Y gastric bypass surgery for patients with type 2 diabetes mellitus and obesity

doi:10.3877/cma.j.issn.1674-3946.2019.06.013.

Abstract

Abstract:

Objective

To investigate the clinical outcome of Roux-en-y gastric bypass surgery (RYGB) on the physiological indexes and insulin resistance of patients with type 2 diabetes mellitus (T2DM) and obesity.

Methods

From October 2012 to December 2017, 86 patients with T2DM and obesity were enrolled in the present study, who underwent laparoscopic Roux-en-Y gastric bypass surgery. Statistical analysis were performed by using SPSS18.0 software. 6 months and 12 months after operation, measurement data such as Glucose and lipid metabolism indexs, pancreatic beta cell function index (HOMA-beta) and insulin resistance index were expressed as mean±standard deviation and were examined by independent t test. A P value of <0.05 was considered as statistically significant.

Results

6 and 12 months after operation, the body weight (BMI) of patients decreased from (33.9±2.6) kg/m² to (27.7±2.7) kg/m² and (26.9±3.1) kg/m² respectively. Indexes of glucose metabolism such as FPG, 2hPG, fasting insulin and HbA1c were decreased significantly after operation (P<0.05). Indexes of lipid metabolism such as TC, TG, LDL-C and HOMA-IR were decreased significantly after operation (P<0.05). However HDL-C and HOMA-β were increased significantly after operation (P<0.05).

Conclusion

RYGB could improve the glucose and lipid metabolism indexes, increase homa-beta cell function and reduce insulin resistance in T2DM patients with obesity.

Key words: Diabetes mellitus, Obesity, Anastomosis, roux-en-Y, Gastric bypass, Insulin resistance

Changsheng Shangguan, Changle Min, Ying Xiang. Clinical investigation of Roux-en-Y gastric bypass surgery for patients with type 2 diabetes mellitus and obesity[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 582-584.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2019.06.013.

https://zhpwkssxzz.cma-cmc.com.cn/EN/Y2019/V13/I06/582

Figures/Tables 3

References 14

[1]	Golden SH, Shab N, Naqibuddin M，et al.The Prevalence and Specificity of Deression Diagnosis in a Chinin－Based Population of Adults With Type 2 Diabetes Mellitus[J]．Psychosomatics，2017，58(1): 28-37.
[2]	张立海，夏宾，王娇，等．Roux－en－Y胃旁路术对2型糖尿病患者近期免疫功能的影响[J]．中华胃肠外科杂志，2016，19(3): 312-316.
[3]	邵得志，冯志毅，张海生，等．胃转流手术治疗非肥胖型2型糖尿病180例疗效观察[J/CD]．中华普外科手术学杂志：电子版，2016，10(1): 50-53.
[4]	Janssen EP, Kohler S, Stehouwer CD，et al.The Patient Health Questionnaire－9as a Sereening tool for Depression in Indinidu－als with Type 2 Diabetes Mellitus：The Maastricht Study [J]．J Am Geriatr Soc，2016，64(11): e201-e206.
[5]	Joseph JJ, Golden SH.Cortisol dysregulation：The bidirectional link between stress，depression，and type 2 diabetes mellitus[J]．Ann N Y Acad Sci，2017，1391(1): 20-34.
[6]	Fujita TR.Unexplained Biliary Dilation after Roux－en－Y Gastric Bypass and Cholecystectomy[J]．J Am Coll Surg，2017，225(4): 566-566.
[7]	Meek CL, Lewis HB, Reimann F，et a1.The effect of bariatric surgery on gastrointestinaland pancreaticpeptide Hormones[J]．Peptides，2016，77(11): 28-37.
[8]	胡瑞翔，杨景哥，杨华，等.450例腹腔镜Roux－en－Y胃旁路术后并发症的分析及处理[J]．中华消化外科杂志，2017，16(6): 582-586.
[9]	Holt PR.RE: Steatorrhea, Hyperoxaluria and Colonic Hyperproliferation After Roux－en－Y Gastric Bypass[J]．Gastroenterology，2017，153(4): 1166-1166.
[10]	杜德晓，宫轲，朱斌，等．腹腔镜Roux－en－Y胃旁路术治疗合并血脂紊乱的2型糖尿病的疗效[J]．中华普通外科杂志，2017，32(2): 137-140.
[11]	杜德晓，宫轲，朱斌，等．FTO基因对Roux－en－Y胃旁路术治疗2型糖尿病疗效的影响[J]．中华普通外科杂志，2017，32(12): 1050-1053.
[12]	高源，吕一峰，马大喜，等．Roux－en－Y胃旁路术对肥胖大鼠脂肪肝的影响及机制研究[J]．同济大学学报(医学版)，2017，38(3): 25-29.
[13]	邵得志，冯志毅，张海生，等.180例胃转流手术治疗2型糖尿病术后并发症防治体会[J/CD]．中华普外科手术学杂志：电子版，2016，10(3): 225-227.
[14]	Pichamol J, Paul TK, Christopher CT. [French comment on article Purse－string transoral outlet reduction (TORe) is effective at inducing weight loss and improvement in metabolic comorbidities after Roux－en－Y gastric bypass][J]．Endoscopy，2018，50(4): 459-460.

时间	FPG(mmol/L)	2hPG(mmol/L)	空腹胰岛素(mIU/L)	HbA1C(%)	空腹C钛(ng/ml)
术前	9.8±1.2	17.7±2.2	12.5±1.7	8.6±1.2	1.1±0.2
术后6月	6.7±0.4^a	9.6±1.4^a	8.0±1.5^a	6.2±0.4^a	0.0±0.2
术后12月	6.0±0.4^ab	9.4±1.3^a	7.8±1.5^a	5.8±0.4^ab	1.0±0.2

时间	FPG(mmol/L)	2hPG(mmol/L)	空腹胰岛素(mIU/L)	HbA1C(%)	空腹C钛(ng/ml)
术前	9.8±1.2	17.7±2.2	12.5±1.7	8.6±1.2	1.1±0.2
术后6月	6.7±0.4^a	9.6±1.4^a	8.0±1.5^a	6.2±0.4^a	0.0±0.2
术后12月	6.0±0.4^ab	9.4±1.3^a	7.8±1.5^a	5.8±0.4^ab	1.0±0.2

时间	TC	TG	HDL－C	LDL－C
术前	4.9±0.8	2.4±0.4	1.2±0.2	3.1±0.4
术后6月	4.2±0.7^a	1.2±0.4^a	1.3±0.3^a	2.5±0.3^a
术后12月	4.2±0.6^a	1.2±0.3^a	1.4±0.3^a	2.5±0.3^a

时间	TC	TG	HDL－C	LDL－C
术前	4.9±0.8	2.4±0.4	1.2±0.2	3.1±0.4
术后6月	4.2±0.7^a	1.2±0.4^a	1.3±0.3^a	2.5±0.3^a
术后12月	4.2±0.6^a	1.2±0.3^a	1.4±0.3^a	2.5±0.3^a

时间	HOMA－β	HOMA－IR	BMI(kg/m²)
术前	50.6±6.0	4.8±0.5	33.9±2.6
术后6月	61.5±7.0^a	2.2±0.3^a	27.7±2.7^a
术后12月	66.4±8.3^ab	2.2±0.3^a	26.9±3.1^a

Please choose a citation manager

Content to export