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Multiple Beneficial Effects of Laparoscopic Sleeve Gastrectomy for Patients with Obesity, Type 2 Diabetes Mellitus, and Restrictive Ventilatory Dysfunction

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Abstract

Background

Some studies have suggested that bariatric surgery improves pulmonary function in patients with obesity, but whether it alleviates pulmonary ventilation disorders in patients with obesity, type 2 diabetes mellitus (T2DM), and restrictive ventilatory dysfunction(RVD) is unclear. To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) in improving pulmonary ventilation function in patients with obesity, T2DM, and RVD.

Methods

We studied patients with T2DM and RVD (forced vital capacity (FVC) predicted < 80%, forced expiratory volume in one second/forced vital capacity (FEV1/FVC) > 70%) who underwent LSG from March 2018 to January 2020. Baseline data was recorded and follow-up visits were made at 3, 6, 9, and 12 months after surgery to evaluate glucose, hemoglobin A1c (HbA1c), body mass index (BMI), and pulmonary ventilation function. We used multivariate analyses to assess the remission of RVD (reversion of FVC to ≥80% of the predicted value).

Results

We enrolled 33 patients (mean age 46.9±5.2 years, 21 males). Two patients were lost to follow-up and another patient died. Thirty patients completed follow-up; 24 had remission of RVD (24/33, 72.7%). Multivariate Cox regression analysis showed that lower HbA1c (HR=0.35 (0.16 ~ 0.76), p=0.008), reduced waist size (0.9 (0.83 ~ 0.98), p=0.017), and shorter duration of diabetes (0.67(0.47~0.97), p=0.033) were associated with alleviation of pulmonary ventilation function.

Conclusions

LSG not only controls the body weight and T2DM; it may also relieve pulmonary ventilation dysfunction in patients with obesity, T2DM, and RVD. The waist size, duration of diabetes, and HbA1c before LSG negatively affect recovery of pulmonary ventilation dysfunction.

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Acknowledgements

We thank John T. Cathey for English language assistance (Peerwith, John Cathey, https://goo.gl/MSJTA7).

Funding

This study was supported by the National Natural Science Foundation of China (82070535), and the Nanchong Government and North Sichuan Medical College Cooperation Project (20SXQT0312).

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Authors and Affiliations

  1. Department of General Surgery, and Institute of Hepato-Biliary-Pancreas and Intestinal Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People’s Republic of China

    Xiaodong Lv, Yin Xian, Xiangxin Kong, Yuan Zhang, Ming He, Junming Cheng, Chicheng Lu & Yixing Ren

  2. Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of China

    Jingge Yang

  3. Xichong County People’s Hospital, Nanchong, 637000, People’s Republic of China

    Chengming Liu

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  1. Xiaodong Lv
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  5. Yuan Zhang
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  7. Ming He
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Correspondence to Yixing Ren.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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

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Key Points

• Bariatric surgery has improved pulmonary ventilation in patients with obesity.

• Whether it alleviates pulmonary ventilation in patients with obesity, T2DM, and RVD is unknown.

• In this study, RVD was alleviated in 80% (24/30) of patients with obesity, T2DM, and RVD.

• Increased HbA1c, increased waist size, and longer duration of diabetes may prevent remission.

Xiaodong Lv, Jingge Yang, and Yin Xian contributed equally to this work and should be considered co-first authors.

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Lv, X., Yang, J., Xian, Y. et al. Multiple Beneficial Effects of Laparoscopic Sleeve Gastrectomy for Patients with Obesity, Type 2 Diabetes Mellitus, and Restrictive Ventilatory Dysfunction. OBES SURG 32, 1016–1023 (2022). https://doi.org/10.1007/s11695-022-05898-0

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  • DOI: https://doi.org/10.1007/s11695-022-05898-0

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