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Effect of Roux-en-Y Gastric Bypass on Remission of T2D: Medium-Term Follow-up in Chinese Patients with Different BMI Obesity Class

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Abstract

Background

Roux-en-Y gastric bypass (RYGB) is an effective treatment for patients with type 2 diabetes mellitus (T2D) with obesity. However, T2D remission after surgery has not been adequately studied in Chinese patients with different obesity classes. The purpose of this study is to evaluate the medium-term metabolic results of RYGB in T2D patients with body mass index (BMI) >25 kg/m2 compared by obesity class.

Methods

We retrospectively divided 120 Chinese patients with T2D and BMI >25 kg/m2 into four groups from overweight to obesity class III and reviewed their medical records for metabolic outcomes 36 months after RYGB. T2D remission was defined as glycated hemoglobin <6.0 % and no current medications. Hypertension, dyslipidemia, cardiovascular risk, and medications were also evaluated.

Results

Sixty-two patients (62/120, 51.6 %) were female. All surgeries were performed laparoscopically without mortality or major complications. Mean follow-up duration was 38.7 ± 9.1 months and follow-up compliance was 86.7 %. Patients with BMI ≥28 kg/m2 benefitted more from weight loss following RYGB. Medication and remission results for hypertension and dyslipidemia did not differ significantly between groups. There was a significant reduction in the need for oral medication or insulin in all four groups. T2D remission occurred in 44–66.7 % of all patients at 36 months with no significant difference between groups. Initial BMI was correlated with A1C 36 months after surgery (r = −0.217, P = 0.027).

Conclusions

RYGB effectively treated T2D patients in our study, even in low-BMI patients, and resulted in diabetes remission and metabolic disorder control, reducing cardiovascular risk.

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Acknowledgments

This study was supported by grants from scientific research funds of the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital (1642), the Chinese Society of Endocrinology, Key Program of the Shanghai Municipality for Basic Research (11 JC1409600), 973 program (2011 CB504001), and the National Major Scientific and Technological Special Project for “Significant New Drugs Development” (2011 ZX09307–001–02).

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Authors and Affiliations

  1. Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, China

    Hongwei Zhang, Xiaodong Han, Jianzhong Di & Pin Zhang

  2. Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, China

    Haoyong Yu & Weiping Jia

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  1. Hongwei Zhang
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  2. Xiaodong Han
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  3. Haoyong Yu
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  5. Pin Zhang
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Correspondence to Pin Zhang.

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Conflict of Interest

The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Hongwei Zhang and Xiaodong Han contributed equally to this work.

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Zhang, H., Han, X., Yu, H. et al. Effect of Roux-en-Y Gastric Bypass on Remission of T2D: Medium-Term Follow-up in Chinese Patients with Different BMI Obesity Class. OBES SURG 27, 134–142 (2017). https://doi.org/10.1007/s11695-016-2262-5

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  • DOI: https://doi.org/10.1007/s11695-016-2262-5

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