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Effects of Laparoscopic Roux-en-Y Gastric Bypass on Chinese Type 2 Diabetes Mellitus Patients with Different Levels of Obesity: Outcomes After 3 Years’ Follow-Up

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Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been proven to be effective on treating type 2 diabetes mellitus (T2DM) in severely obese patients, but whether LRYGB surgery should be performed in obese class I patients is controversial.

Materials and Methods

A retrospective study of 3-year bariatric and metabolic outcomes in different obese class T2DM patients who underwent LRYGB was conducted to compare the effectiveness of LRYGB in obese class I patients with that in obese class II/III patients in a Chinese T2DM population.

Results

Totally, 58 patients with class I obesity and 45 patients with class II/III obesity were enrolled in this study. Major complications included two cases of incomplete intestinal obstructions and one anastomotic leak. The remission rates of T2DM were 70.6% in obese class I group and 77.8% in obese class II/III group at 1 year after surgery and 55.6 versus 64.3% at 3 years (all P > 0.05). Logistic regression analysis showed that higher waist circumference, lower fasting plasma glucose, and higher FCP at 2 h of OGTT were independently associated with diabetes remission at 1 year after surgery. At 1 year and thereafter, the percentage of excess weight loss was significantly greater in obese class II/III patients. At 3 years, body mass index was not significantly different between the two groups, and the obese class I patients had high recurrence rates of hypertension and hyperuricemia.

Conclusions

LRYGB surgery is feasible, safe, and effective in Chinese obese class I patients with T2DM.

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Acknowledgments

The study is an internal teamwork from the Multi-disciplinary Treatment Group of Bariatric and Metabolic Surgery (BMS-MDT) and Gastrointestinal Tract Reconstruction and Metabolic Surgery Association (GIRMSA), West China Hospital, Sichuan University.

Funding

The study is supported by the National Natural Science Foundation of China (81502613), Sichuan Province Science and Technology Support Program (2014SZ0002-5), and Xindu Social Science and Technology Development Project (20160740401).

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, People’s Republic of China

    Xiao Du, Jian-kun Hu, Zong-guang Zhou & Zhong Cheng

  2. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China

    Xiang-hui Fu

  3. Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China

    Lei Shi

Authors
  1. Xiao Du
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  2. Xiang-hui Fu
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  3. Lei Shi
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  4. Jian-kun Hu
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  5. Zong-guang Zhou
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  6. Zhong Cheng
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Corresponding author

Correspondence to Zhong Cheng.

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Conflict of Interest

All authors declare that they have no conflicts of interest.

Statement of Informed Consent

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

Statement of Human and Animal Rights

This study was performed in accordance with the principles of the Declaration of Helsinki and was approved by the Research and Ethics Committee of West China Hospital.

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Du, X., Fu, Xh., Shi, L. et al. Effects of Laparoscopic Roux-en-Y Gastric Bypass on Chinese Type 2 Diabetes Mellitus Patients with Different Levels of Obesity: Outcomes After 3 Years’ Follow-Up. OBES SURG 28, 702–711 (2018). https://doi.org/10.1007/s11695-017-2903-3

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