减肥手术对糖尿病的影响：长期结果数据的荟萃分析

Q2 Medicine

Obesity Medicine Pub Date : 2025-09-01 DOI:10.1016/j.obmed.2025.100645

Grace C. Bloomfield , Marcus H. Cunningham , Mike Y. Chen , Dan E. Azagury , Yewande R. Alimi , Nicholas J. Prindeze

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引用次数: 0

摘要

背景：减肥手术是一种行之有效的减肥和减少肥胖相关合并症的方法。虽然肥胖和2型糖尿病之间的联系已经确立，但减肥手术对糖尿病患者的长期影响尚不清楚。方法对2000年至2024年间报告Roux-en-Y胃旁路、胃套管或药物减肥控制结果的研究进行荟萃分析。收集并分析BMI、2型糖尿病和高血压的数据。结果共纳入20项研究，4092例患者。1年时，糖尿病患者与普通人群的总体重减轻35 - 40% （TWL）相似，但到10-12年时，糖尿病患者与普通人群的总体重减轻35 - 40% （TWL）相似；然而，在10-12年，当普通人群下降到23 - 28%的TWL时，糖尿病组保持了35 - 39%的TWL。糖尿病组的短期糖尿病治愈率为83 - 85%，普通人群为63 - 85%。然而，糖尿病患者的长期糖尿病反弹率更高，前者为26 - 51%，后者为26 - 60%。糖尿病患者1年高血压治愈率为44 - 55%，低于63 - 73%，长期数据不足。在任何时候，对照组的糖尿病和高血压发病率都持续恶化。结论减肥手术治疗糖尿病疗效显著；然而，长期结果与一般人群不同。虽然两组患者的初始体重都有显著下降，但糖尿病患者的体重控制较好，但糖尿病复发率较高。Roux-en-Y胃旁路术在所有测量结果中都优于胃套管术。

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Antidiabetic impact of bariatric surgery: A meta-analysis of long-term outcome data

Background

Bariatric surgery is a proven method for weight loss and reducing obesity-related comorbidities. While the link between obesity and type 2 diabetes is well established, the long-term impact of bariatric surgery on diabetic patients remains unclear.

Methods

A meta-analysis was conducted between 2000 and 2024 on studies reporting outcomes of Roux-en-Y gastric bypass, gastric sleeve, or medical weight loss controls. Data on BMI, type 2 diabetes, and hypertension were collected and analyzed.

Results

A total of 20 studies with 4092 patients were included. At 1-year weight loss was similar between the diabetic and general populations at 35–40 % total weight loss (TWL), however by 10–12 years1 year, weight loss was similar between the diabetic and general populations at 35–40 % total weight loss (TWL); however, by 10–12 years, while the general population dropped to 23–28 % TWL, the diabetic group maintained an improved 35–39 % TWL. Short-term diabetes resolution was 83–85 % in the diabetic group and 63–85 % in the general population. However, the long-term diabetes rebound was greater in diabetics, with a rate of 26–51 % resolution vs. 26–60 %. Hypertension resolution at 1-year was lower in diabetics at 44–55 % vs. 63–73 %, with insufficient long-term data. At all times, control groups showed persistent worsening of diabetes and hypertension rates.

Conclusions

Bariatric surgery is highly effective for diabetic patients; however long-term outcomes differ from those of the general population. While both groups experienced significant initial weight loss, diabetics maintained better weight control but had higher diabetes recurrence. Roux-en-Y gastric bypass outperformed the gastric sleeve in all measured outcomes.

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来源期刊

Obesity Medicine Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.50

自引率

0.00%

发文量

审稿时长

40 days

期刊介绍： The official journal of the Shanghai Diabetes Institute Obesity is a disease of increasing global prevalence with serious effects on both the individual and society. Obesity Medicine focusses on health and disease, relating to the very broad spectrum of research in and impacting on humans. It is an interdisciplinary journal that addresses mechanisms of disease, epidemiology and co-morbidities. Obesity Medicine encompasses medical, societal, socioeconomic as well as preventive aspects of obesity and is aimed at researchers, practitioners and educators alike.