Preoperative contributing factors and the remission of diabetes after metabolic surgery: the mediating role of preoperative triglyceride.

IF 2.9 3区 医学 Q2 PSYCHIATRY
Lijuan Niu, Liqian Mu, Runda Wu, Shan Tong, Zhongqi Mao, Yi Yang, Jun Yin
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Abstract

Background and objective: Limited understanding exists regarding the factors affecting the prognosis of surgical treatment for type 2 diabetes mellitus (T2DM), particularly in Chinese patients. In this study, we examined a cohort of early and intermediate obese T2DM patients to explore the potential impact of preoperative lipid metabolism in metabolic surgery on the postoperative remission of T2DM.

Methods: Participants with T2DM and obesity underwent metabolic surgery. Clinical data, including baseline body mass index, percentage of excess weight loss, and preoperative biochemical indicators, were collected and analyzed. A multidisciplinary team conducted patient follow-up. Remission was defined as sub-diabetic hyperglycemia (HbA1c < 48 mmol/mol, fasting glucose 100-125 mg/dl) without pharmacological intervention for at least 12 months.

Results: Over a median follow-up of 27 months, 96 T2DM patients with metabolic surgery were studied, with no laparotomies required. Among these patients, 61 (63.5%) achieved complete remission, and 85 (88.5%) experienced remission. In multivariable analysis models, preoperative fasting blood glucose (FBG) significantly correlated with all postoperative outcomes. Furthermore, mediation analysis indicated that preoperative triglycerides (TG) mediated 26.31% of the association between preoperative FBG and postoperative remission. Both preoperative FBG and TG were negatively associated with the postoperative remission of T2DM.

Conclusion: In summary, our findings suggest that lower preoperative fasting glucose levels enhance the likelihood of postoperative T2DM remission. Moreover, preoperative TG could potentially play a mediating role in the postoperative remission of T2DM. Therefore, evaluating and managing fasting glucose and lipids before the procedure may aid in assessing the prognosis of metabolic surgery. Level of evidence Level III, designed cohort.

Abstract Image

术前诱因与代谢手术后糖尿病的缓解:术前甘油三酯的中介作用。
背景和目的:人们对影响2型糖尿病(T2DM)外科治疗预后的因素了解有限,尤其是在中国患者中。在本研究中,我们对一组早期和中期肥胖的 T2DM 患者进行了研究,以探讨代谢手术中术前血脂代谢对 T2DM 术后缓解的潜在影响:方法:患有 T2DM 和肥胖症的患者接受代谢手术。收集并分析临床数据,包括基线体重指数、超重百分比和术前生化指标。多学科团队对患者进行随访。缓解被定义为亚糖尿病高血糖(HbA1c 结果):在中位 27 个月的随访期间,共对 96 名接受代谢手术的 T2DM 患者进行了研究,其中没有人需要开腹手术。在这些患者中,61 人(63.5%)的病情得到完全缓解,85 人(88.5%)的病情得到缓解。在多变量分析模型中,术前空腹血糖(FBG)与所有术后结果都有显著相关性。此外,中介分析表明,术前甘油三酯(TG)介导了 26.31% 的术前 FBG 与术后缓解之间的关联。术前 FBG 和甘油三酯均与 T2DM 术后缓解呈负相关:总之,我们的研究结果表明,术前较低的空腹血糖水平会提高 T2DM 术后缓解的可能性。此外,术前 TG 有可能在 T2DM 术后缓解过程中起到中介作用。因此,在术前评估和管理空腹血糖和血脂可能有助于评估代谢手术的预后。证据等级 III 级,设计队列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.50
自引率
10.30%
发文量
170
审稿时长
>12 weeks
期刊介绍: Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.
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