肥胖和糖尿病患者腹腔镜袖式胃切除术后尿酸水平改善的BMI和性别差异。

Postgraduate medicine Pub Date : 2025-04-01 Epub Date: 2025-04-20 DOI:10.1080/00325481.2025.2493040
Bian Wu, Kunlin Li, Junyu Wang, Guishun Sun, Shiwen Li, Xuan He, Rongzhuang Zou, Lihong Jiang
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引用次数: 0

摘要

背景:肥胖合并2型糖尿病(T2DM)患者腹腔镜袖式胃切除术(LSG)后尿酸(UA)水平的潜在改善尚未得到系统研究。我们的目的是探讨LSG后UA水平提高的影响因素及其与糖代谢和脂代谢的关系。方法:从2022年11月1日至2023年12月31日,共招募392名肥胖和T2DM患者。所有患者均行LSG手术,术后1、2、3、6、12个月随访。记录术前、术后体重指数(BMI)、UA及糖代谢、脂代谢指标。结果:在LSG后,男性和女性之间以及不同BMI组之间的UA均有明显改善。在所有BMI组中,女性患者在长达12个月的UA水平恢复中比男性患者表现出更持久和更大的恢复,尽管男性患者在前两个月的UA水平下降幅度更大。此外,BMI≥37.5的患者在12个月内的UA水平下降幅度明显大于其他患者。在三个BMI组中,女性UA水平的改善与BMI的改善均有显著相关性,而男性仅与BMI 28-32.5组相关。葡萄糖代谢方面,术前UA水平升高组患者以及女性患者的空腹血糖(FBG)、空腹胰岛素(FBI)、糖化血红蛋白(HbA1c)、c肽(CP)与UA水平变化呈显著的线性相关。脂质代谢方面,仅女性患者和术前UA水平高的患者的UA水平变化与HDL呈显著的线性相关。结论:性别和手术前BMI似乎影响LSG后UA的改善。女性和术前UA水平升高的患者UA水平缓解最为显著。尿酸水平的变化还与糖代谢和脂代谢相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
BMI and sex disparity in uric acid level improvement in patients with obesity and diabetes following laparoscopic sleeve gastrectomy.

Background: The potential improvement in uric acid (UA) levels following laparoscopic sleeve gastrectomy (LSG) in patients with obesity and type II diabetes mellitus (T2DM) has not been systematically studied. Our aim was to investigate the influencing factors of UA level improvement following LSG and its correlation with glucose metabolism and lipid metabolism.

Methods: A total of 392 patients with obesity and T2DM were prospectively recruited from 1 November 2022 to 31 December 2023. All patients underwent LSG surgery and were followed at 1, 2, 3, 6, 12 months after surgery. The presurgical and postsurgical levels of body-mass index(BMI), UA and indicators of glucose metabolism and lipid metabolism were recorded.

Results: Distinct UA improvement was observed between males and females and among different BMI groups following LSG. Female patients exhibited more sustained and greater recovery of UA level up to 12 months than male patients in all BMI groups, although male patients showed a sharper UA level decrease in the first two months. Furthermore, patients with BMI ≥ 37.5 appeared to have significantly greater UA level decrease than other patients up to 12 months. UA level improvement showed significant correlation with BMI improvement in all three BMI groups in females while only in BMI 28-32.5 group in males. For glucose metabolism, a significant linear correlation between UA level changes and fasting blood glucose (FBG), fasting blood insulin (FBI), glycosylated hemoglobin A1c (HbA1c) and C-peptide (CP) was found in patients with presurgical elevated UA level group, and in female patients for FBI and CP. For lipid metabolism, a significant linear correlation was only observed between UA level changes and HDL in female and those with high presurgical UA levels.

Conclusions: Sex and presurgical BMI appeared to influence the UA improvement following LSG. Females and those with presurgical elevated UA levels exhibited the most significant UA level alleviation. UA level changes also correlated with glucose metabolism and lipid metabolism.

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