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Metabolic Syndrome After Roux-en-Y Gastric Bypass Surgery in Chinese Obese Patients with Type 2 Diabetes

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Abstract

Background

Roux-en-Y gastric bypass (RYGB) surgery is currently the most effective treatment for substantial and sustained weight loss in morbidly obese individuals. We aim to determine the prevalence in Chinese obese patients with type 2 diabetes (T2DM) and the efficacy of surgical treatment of the metabolic syndrome (MetS) and its components with a control group in medical therapy.

Methods

A total of 121 obese T2DM individuals who underwent RYGB and 93 nonoperative obese patients with T2DM were enrolled in the study. MetS was defined according to the criteria established by the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults (JCDCG). We determined the change in MetS and the prevalence of its components and performed logistic regression models to evaluate predictors of MetS remission.

Results

One year after RYGB, all MetS components improved in the RYGB group and medication use decreased. Of the RYGB group, MetS prevalence decreased from 108 patients (83.3 %) to 20 (16.5 %), and from 88 patients (94.6 %) to 76 (81.7 %) in the control group. Multiple logistic regression analyses indicated that a shorter diabetes duration and higher percent excess weight loss (%EWL) were associated with a greater chance of MetS remission after surgery.

Conclusions

RYGB induces considerable and persistent improvement in MetS prevalence in Chinese obese patients with T2DM. Diabetes duration and %EWL might act as potential prognostic markers in predicting the MetS reversibility.

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Acknowledgments

This study was supported by grants from the Chinese Society of Endocrinology, Key Program of the Shanghai Municipality for Basic Research (11JC1409600), 973 program (2011CB504001), National Major Scientific and Technological Special Project for “Significant New Drugs Development” (2011ZX09307-001-02), National Natural Science Foundation of China (2014DFA31870), The innovation foundation of translational medicine of Shanghai Jiao Tong University School of Medicine, and Shanghai SJTUSM Biobank.

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    Authors and Affiliations

    1. Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, China

      Haoyong Yu, Lei Zhang, Yuqian Bao, Yinfang Tu, Junfeng Han & Weiping Jia

    2. Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, China

      Pin Zhang, Jianzhong Di & Xiaodong Han

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    1. Haoyong Yu
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    Correspondence to Weiping Jia.

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    Statement of Informed Consent

    Informed consent was obtained from all individual participants included in the study.

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    This study was approved by the Ethics Committee of the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and complied with the Declaration of Helsinki.

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    Haoyong Yu and Lei Zhang contributed equally to this work.

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    Yu, H., Zhang, L., Bao, Y. et al. Metabolic Syndrome After Roux-en-Y Gastric Bypass Surgery in Chinese Obese Patients with Type 2 Diabetes. OBES SURG 26, 2190–2197 (2016). https://doi.org/10.1007/s11695-016-2074-7

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