The authors declare that they have no competing interests.
YJJ and WCC designed the study. WCC, YJJ, CG and YW performed the surgeries and conducted the study. YSQ and ZHN collected the data and performed the statistical analysis. PYL helped to draft the manuscript. All authors approved the final manuscript.
To compare long term effects of two bariatric procedures for Chinese type 2 diabetes mellitus (T2DM) patients with a body mass index (BMI) of 28-35 kg/m2.
Sixty four T2DM patients with Glycated hemoglobin A1c (HbA1c) ≧ 7.0 % were randomly assigned to receive laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) procedure. Weight, percentage of excess weight loss (%EWL), BMI, waist circumference, HbA1c, fasting blood glucose (FBG), and C-peptide were measured. Serum lipid levels were also measured during three-year postoperative follow-up visits.
Fifty five patients completed the 36-month follow-up. Both groups had similar baseline anthropometric and biochemical measures. At the end point, 22 patients (78.6 %) in SG group and 23 patients (85.2 %) in RYGB group achieved complete remission of diabetes mellitus with HbA1c < 6.0 % (P = 0.525) and without taking diabetic medications, and 25 patients in each group (89.3 % vs. 92.6 %) gained successful treatment of diabetes with HbA1c≦6.5 % (P = 0.100). Change in HbA1c, FBG and C peptide were comparable in the two groups. The RYGB group had significantly greater weight loss than the SG group [percentage of total weight loss (%TWL) of 31.0 % vs. 27.1 % (P = 0.049), %EWL of 92.3 % vs. 81.9 % (P = 0.003), and change in BMI of 11.0 vs. 9.1 kg/m2(P = 0.017), respectively]. Serum lipids in each group were also greatly improved.
In this three-year study, SG had similar positive effects on diabetes and dyslipidemia compared to RYGB in Chinese T2DM patients with BMI of 28-35 kg/m2. Longer term follow-ups and larger sample studies are needed to confirm these outcomes, however.
Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Leccesi L, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–85.
Alexandrou A, Athanasiou A, Michalinos A, Felekouras E, Tsigris C, Diamantis T. Laparoscopic sleeve gastrectomy for morbid obesity: 5-year results. Am J Surg. 2014 Jun 20. pii: S0002-9610 (14) 00262-1. doi: 10.1016/j.amjsurg.2014.04.006. [Epub ahead of print]
Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2010;310(9):948–59. CrossRef
Al SJ. STAMPEDE: Bariatric surgery gains more evidence based support. Glob Cardiol Sci Pract. 2014;2014(1):45–8.
Wang J, Thornton JC, Russell M, Burastero S, Heymsfield S, Pierson Jr RN. Asians have lower body mass index (BMI) but higher percent body fat than do whites: comparisons of anthropometric measurements. Am J Clin Nutr. 1994;60(1):23–8. PubMed
Lakdawala M, Bhasker A. Asian consensus meeting on metabolic surgery (ACMOMS).Asian consensus meeting on metabolic surgery (ACMOMS).report: Asian consensus meeting on metabolic surgery. Recommendations for the use of bariatric and gastrointestinal metabolic surgery for treatment of obesity and type 2 diabetes mellitus in the Asian population: august 9th and 10th, 2008, Trivandrum, India. Obes Surg. 2010;20(7):929–36. CrossRefPubMed
Li K, Gao F, Xue H, Jiang Q, Wang Y, Shen Q, et al. Comparative study on laparoscopic sleeve gastrectomy and laparoscopic gastric bypass for treatment of morbid obesity patients. Hepatogastroenterol. 2014;61(130):319–22.
Eickhoff H, Guimarães A, Louro TM, Seiça RM, Castro E Sousa F. Insulin resistance and beta cell function before and after sleeve Gastrectomy in obese patients with impaired fasting glucose or type 2 diabetes. Surg Endosc. 2014 Jul 4. [Epub ahead of print].
- Long-term effects of laparoscopic sleeve gastrectomy versus roux-en-Y gastric bypass for the treatment of Chinese type 2 diabetes mellitus patients with body mass index 28-35 kg/m2
- BioMed Central
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