Xiao Du1, Xiang-Hui Fu2, Lei Shi3, Jian-Kun Hu1, Zong-Guang Zhou1, Zhong Cheng4. 1. Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, People's Republic of China. 2. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. 3. Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China. 4. Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, People's Republic of China. zhongcheng1963@126.com.
Abstract
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been proven to be effective on treating type 2 diabetes mellitus (T2DM) in severely obese patients, but whether LRYGB surgery should be performed in obese class I patients is controversial. MATERIALS AND METHODS: A retrospective study of 3-year bariatric and metabolic outcomes in different obese class T2DM patients who underwent LRYGB was conducted to compare the effectiveness of LRYGB in obese class I patients with that in obese class II/III patients in a Chinese T2DM population. RESULTS: Totally, 58 patients with class I obesity and 45 patients with class II/III obesity were enrolled in this study. Major complications included two cases of incomplete intestinal obstructions and one anastomotic leak. The remission rates of T2DM were 70.6% in obese class I group and 77.8% in obese class II/III group at 1 year after surgery and 55.6 versus 64.3% at 3 years (all P > 0.05). Logistic regression analysis showed that higher waist circumference, lower fasting plasma glucose, and higher FCP at 2 h of OGTT were independently associated with diabetes remission at 1 year after surgery. At 1 year and thereafter, the percentage of excess weight loss was significantly greater in obese class II/III patients. At 3 years, body mass index was not significantly different between the two groups, and the obese class I patients had high recurrence rates of hypertension and hyperuricemia. CONCLUSIONS: LRYGB surgery is feasible, safe, and effective in Chinese obese class I patients with T2DM.
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been proven to be effective on treating type 2 diabetes mellitus (T2DM) in severely obesepatients, but whether LRYGB surgery should be performed in obese class I patients is controversial. MATERIALS AND METHODS: A retrospective study of 3-year bariatric and metabolic outcomes in different obese class T2DM patients who underwent LRYGB was conducted to compare the effectiveness of LRYGB in obese class I patients with that in obese class II/III patients in a Chinese T2DM population. RESULTS: Totally, 58 patients with class I obesity and 45 patients with class II/III obesity were enrolled in this study. Major complications included two cases of incomplete intestinal obstructions and one anastomotic leak. The remission rates of T2DM were 70.6% in obese class I group and 77.8% in obese class II/III group at 1 year after surgery and 55.6 versus 64.3% at 3 years (all P > 0.05). Logistic regression analysis showed that higher waist circumference, lower fasting plasma glucose, and higher FCP at 2 h of OGTT were independently associated with diabetes remission at 1 year after surgery. At 1 year and thereafter, the percentage of excess weight loss was significantly greater in obese class II/III patients. At 3 years, body mass index was not significantly different between the two groups, and the obese class I patients had high recurrence rates of hypertension and hyperuricemia. CONCLUSIONS: LRYGB surgery is feasible, safe, and effective in Chinese obese class I patients with T2DM.
Entities:
Keywords:
Bariatric surgery; Class I obesity; Low body mass index; Roux-en-Y gastric bypass; Type 2 diabetes mellitus
Authors: Juliana C N Chan; Vasanti Malik; Weiping Jia; Takashi Kadowaki; Chittaranjan S Yajnik; Kun-Ho Yoon; Frank B Hu Journal: JAMA Date: 2009-05-27 Impact factor: 56.272
Authors: C L Leibson; D F Williamson; L J Melton; P J Palumbo; S A Smith; J E Ransom; P L Schilling; K M Narayan Journal: Diabetes Care Date: 2001-09 Impact factor: 19.112
Authors: Camilo Boza; Patricio Valderas; David A Daroch; Felipe I León; José P Salinas; Diego A Barros; Ricardo A Funke; Fernando J Crovari Journal: Obes Surg Date: 2014-08 Impact factor: 4.129
Authors: John B Buse; Sonia Caprio; William T Cefalu; Antonio Ceriello; Stefano Del Prato; Silvio E Inzucchi; Sue McLaughlin; Gordon L Phillips; R Paul Robertson; Francesco Rubino; Richard Kahn; M Sue Kirkman Journal: Diabetes Care Date: 2009-11 Impact factor: 19.112
Authors: Ricardo V Cohen; Jose C Pinheiro; Carlos A Schiavon; João E Salles; Bernardo L Wajchenberg; David E Cummings Journal: Diabetes Care Date: 2012-07 Impact factor: 19.112