Journal of Surgery Concepts & Practice ›› 2020, Vol. 25 ›› Issue (05): 397-401.doi: 10.16139/j.1007-9610.2020.05.009
• Original article • Previous Articles Next Articles
ZHANG Chenyang1a, ZHANG Hongwei1a, HAN Xiaodong1a, LIU Weijie1a, YU Haoyong1b,2, ZHANG Pin1a()
Received:
2020-07-23
Online:
2020-09-25
Published:
2022-07-27
CLC Number:
ZHANG Chenyang, ZHANG Hongwei, HAN Xiaodong, LIU Weijie, YU Haoyong, ZHANG Pin. Comparative study on weight loss and remission of metabolic disorders after laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy[J]. Journal of Surgery Concepts & Practice, 2020, 25(05): 397-401.
指标 | 组别 | 术前 | 术后3个月 | 术后6个月 | 术后12个月 | 术后24个月 |
---|---|---|---|---|---|---|
BMI | LRYGB | 35.07±3.96 | 28.18±3.21** | 26.89±3.11** | 26.60±2.63** | 26.93±2.81** |
LSG | 35.47±4.12 | 28.90±3.79** | 26.73±3.53** | 26.07±3.55** | 27.09±3.66** | |
收缩压 (mmHg) | LRYGB | 138.07±16.16 | 129.14±17.07** | 125.12±13.80** | 125.80±10.94** | 126.50±15.51** |
LSG | 136.45±18.14 | 132.72±14.28 | 127.03±17.93* | 123.96±14.95** | 127.00±15.13* | |
舒张压(mmHg) | LRYGB | 85.21±10.88 | 81.26±11.46 | 78.09±9.27** | 78.73±7.31** | 77.40±10.37** |
LSG | 87.25±11.13 | 83.27±11.59 | 82.21±10.79 | 78.06±9.99** | 80.40±12.55* | |
HbA1c (%) | LRYGB | 7.96±1.68 | 5.75±0.75** | 5.68±0.76** | 5.75±0.66** | 5.87±0.81** |
LSG | 7.85±1.68 | 5.84±0.65** | 5.75±0.78** | 5.77±0.75** | 5.71±0.68** | |
FPG(mmol/L) | LRYGB | 8.41±2.54 | 5.46±1.22** | 5.22±0.91** | 5.56±1.21** | 5.39±0.92** |
LSG | 8.29±2.56 | 5.44±0.86** | 5.35±0.97** | 5.30±1.02** | 5.14±0.59** | |
PBG(mmol/L) | LRYGB | 13.61±4.22 | 6.56±2.14** | 6.64±2.41** | 6.53±2.48** | 6.40±2.26** |
LSG | 12.83±3.75 | 6.55±1.94** | 5.89±1.57** | 6.22±2.45** | 5.87±1.49** | |
HOMA-IR | LRYGB | 6.42(4.96,11.27) | 2.02(1.21,3.62)** | 1.42(1.03,2.39)** | 1.44(1.19,2.72)** | 1.32(1.14,2.79)** |
LSG | 7.78(4.95,11.31) | 1.97(1.40, 2.76)** | 1.61(1.20,2.15)** | 1.61(0.96,2.14)** | 1.83(1.30,2.36)** | |
空腹C肽(nmol/L) | LRYGB | 1.09±0.09 | 0.85±0.07** | 0.77±0.05** | 0.69±0.04** | 0.69±0.05** |
LSG | 1.21±0.09 | 0.87±0.06** | 0.68±0.04** | 0.72±0.05** | 0.73±0.05** | |
空腹胰岛素(pmol/L) | LRYGB | 18.99(12.77,30.1) | 8.10(5.91,14.45)** | 6.56(4.51,8.87)** | 6.76(4.85,11.39)** | 6.15(4.54,12.64)** |
LSG | 20.85(13.50,29.1) | 8.25(5.85,11.05)** | 6.86(4.47,9.31)** | 7.15(4.95,9.08)** | 7.74(5.80,9.86)** |
指标 | 组别 | 术前 | 术后3个月 | 术后6个月 | 术后12个月 | 术后24个月 |
---|---|---|---|---|---|---|
Tc (mmol/L) | ||||||
LRYGB | 5.44±1.84 | 4.29±0.87** | 4.04±0.79** | 4.19±0.92** | 4.31±0.94** | |
LSG | 5.05±1.28 | 5.41±1.08## | 5.08±1.09## | 4.99±1.05## | 5.36±1.22## | |
Tg (mmol/L) | ||||||
LRYGB | 3.19±2.97 | 1.40±0.67** | 1.23±0.57** | 1.11±0.41** | 1.25±0.53** | |
LSG | 2.71±1.91 | 1.47±0.63** | 1.25±0.48** | 1.11±0.41** | 1.28±0.79** | |
HDL-c (mmol/L) | ||||||
LRYGB | 1.03±0.23 | 1.04±0.22 | 1.16±0.23* | 1.26±0.2** | 1.26±0.29** | |
LSG | 0.99±0.14 | 1.08±0.24** | 1.19±0.26** | 1.28±0.29** | 1.34±0.36** | |
LDL-c (mmol/L) | ||||||
LRYGB | 2.97±0.85 | 2.55±0.73** | 2.25±0.7** | 2.32±0.64** | 2.39±0.70** | |
LSG | 2.95±0.94 | 3.42±0.83##* | 3.16±0.91## | 2.98±0.96## | 3.22±0.94## | |
ASI | ||||||
LRYGB | 4.57±2.85 | 3.23±1.01** | 2.54±0.81** | 2.35±0.77** | 2.53±0.91** | |
LSG | 4.19±1.49 | 4.19±1.45## | 3.47±1.43##* | 3.03±1.15##** | 3.18±1.09##** |
[1] |
中华医学会糖尿病学分会. 中国 2 型糖尿病防治指南(2017 年版)[J]. 中国实用内科杂志, 2018, 38(4):292-344.
doi: 10.19538/j.nk2018040108 |
[2] |
Woelnerhanssen B, Peterli R, Steinert RE, et al. Effects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial[J]. Surg Obes Relat Dis, 2011, 7(5):561-568.
doi: 10.1016/j.soard.2011.01.044 pmid: 21429816 |
[3] | Ting CH, Syu YF, Chen LY, et al. Perspectives on interventional diabetology: duodenal exclusion is promising for human type 2 diabetes mellitus remission[J]. Nutrition, 2016, 32(1):141-145. |
[4] |
Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial[J]. Ann Surg, 2009, 250(2):234-241.
doi: 10.1097/SLA.0b013e3181ae32e3 pmid: 19638921 |
[5] | English WJ, DeMaria EJ, Hutter MM, et al. American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States[J]. Surg Obes Relat Dis,2020, 16(4):457-463. |
[6] | le Roux CW, Welbourn R, Werling M, et al. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric by-pass[J]. Ann Surg, 2007, 246(5):780-785. |
[7] |
Dimitriadis E, Daskalakis M, Kampa M, et al. Alterations in gut hormones after laparoscopic sleeve gastrectomy: a prospective clinical and laboratory investigational study[J]. Ann Surg, 2013, 257(4):647-654.
doi: 10.1097/SLA.0b013e31826e1846 pmid: 23108120 |
[8] | 中华医学会外科学分会甲状腺及代谢外科学组, 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 中国肥胖及2型糖尿病外科治疗指南(2019版)[J]. 中国实用外科杂志, 2019, 39(4):301-306. |
[9] |
Peterli R, Steinert R, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial[J]. Obes Surg, 2012, 22(5):740-748.
doi: 10.1007/s11695-012-0622-3 pmid: 22354457 |
[10] | Paluszkiewicz R, Kalinowski P, Wroblewski T, et al. Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity[J]. Wideochir Inne Tech Malo Inwazyjne, 2012, 7(4):225-232. |
[11] |
Alexandrou A, Armeni E, Kouskouni E, et al. Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study[J]. Surg Obes Relat Dis, 2014, 10(2):262-268
doi: 10.1016/j.soard.2013.07.014 pmid: 24182446 |
[12] | Otto M, Elrefai M, Krammer J, et al. Sleeve gastrectomy and Roux-en-Y gastric bypass lead to comparable changes in body composition after adjustment for initial body mass index[J]. Obes Surg, 2016, 26(3):479-485. |
[13] |
Wang MC, Guo XH, Zhang YW, et al. Laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy for obese patients with type 2 diabetes: a meta-analysis of randomized controlled trials[J]. Am Surg, 2015, 81(2):166-171.
pmid: 25642879 |
[14] | Vix M, Diana M, Liu KH, et al. Evolution of glycolipid profile after sleeve gastrectomy vs. Roux-en-Y gastric bypass: results of a prospective randomized clinical trial[J]. Obes Surg, 2013, 23(5):613-621. |
[15] |
Panunzi S, Carlsson L, De Gaetano A, et al. Determinants of diabetes remission and glycemic control after bariatric surgery[J]. Diabetes Care, 2016, 39(1):166-174.
doi: 10.2337/dc15-0575 pmid: 26628418 |
[16] | Lewis KH, Arterburn DE, Zhang F, et al. Comparative effectiveness of vertical sleeve gastrectomy versus Roux-en-Y gastric bypass for diabetes treatment: a claims-based cohort study[J]. Ann Surg, 2019-06-12.[Epub ahead of print]. |
[17] |
Ahmed AR, Rickards G, Coniglio D, et al. Laparscopic Roux-en-Y gastric bypass and its early effect on blood pressure[J]. Obes Surg, 2009, 19(7):845-849.
doi: 10.1007/s11695-008-9671-z pmid: 18758869 |
[18] |
Griffo E, Cotugno M, Nosso G, et al. Effects of sleeve gastrectomy and gastric bypass on postprandial lipid profile in obese type 2 diabetic patients: a 2-year follow-up[J]. Obes Surg, 2016, 26(6):1247-1253.
doi: 10.1007/s11695-015-1891-4 pmid: 26435537 |
[19] | Benetti A, Del Puppo M, Crosignani A, et al. Cholesterol metabolism after bariatric surgery in grade 3 obesity: differences between malabsorptive and restrictive procedures[J]. Diabetes Care, 2013, 36(6):1443-1447. |
[20] |
Maraninchi M, Padilla N, Beliard S, et al. Impact of bariatric surgery on apolipoprotein C-Ⅲ levels and lipoprotein distribution in obese human subjects[J]. J Clin Lipidol, 2017, 11(2):495-506.
doi: S1933-2874(17)30040-5 pmid: 28502507 |
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