代谢手术对非肥胖2型糖尿病患者体质指数-第三军医大学学报.DOCVIP

PAGE PAGE 4 代谢手术对肥胖与非肥胖2型糖尿病患者体质指数、胰岛素抵抗及血脂影响 孙 芳1，闫振成1 ，陈 静1，倪银星1，高 羽2，童卫东2，祝之明1 （400042重庆，第三军医大学大坪医院野战外科研究所：全军高血压代谢病中心，重庆大坪医院高血压内分泌科，重庆市高血压研究所1，胃结直肠外科2） [摘要] 目的 比较代谢手术对肥胖与非肥胖2型糖尿病患者术后体质指数(BMI)及代谢指标的总体效果差异。方法 以体质指数28为切点，分为肥胖糖尿病组（BMI≥28，n=10）及非肥胖糖尿病组（BMI28，n=10），术前配比各项基础资料，术后3～6月随访体质指数、葡萄糖耐量及胰岛素释放、尿酸、总胆固醇、低密度脂蛋白胆固醇水平，比较各组手术前后的差异以及两组术后效果的差异。结果 相关分析发现非肥胖患者（BMI28）术后BMI下降程度与术前BMI无相关（r=0.416, P=0.232），而肥胖患者（BMI≥28）术后BMI下降程度则与术前BMI高低明显相关（r=0.932, P =0.000）。非肥胖患者与肥胖患者手术前后胰岛素抵抗程度、总胆固醇水平均明显改善(P 0.05)，而尿酸代谢、低密度脂蛋白胆固醇水平均无明显变化。两组患者术后在体质指数的下降程度差异明显，肥胖患者较非肥胖患者下降更明显，而两组患者术后在胰岛素抵抗、总胆固醇水平的改善程度上并无显著性差异。结论 代谢手术能明显改善肥胖与非肥胖糖尿病患者术后体重、胰岛素抵抗及血脂，且非肥胖2型糖尿病患者与肥胖2型糖尿病患者术后总胆固醇、低密度脂蛋白及胰岛素抵抗改善获益相当，肥胖与否改为“BMI是否大于28”不能作为是否手术的 改为“BMI是否大于28” [关键词] 糖尿病；代谢手术；肥胖；体质指数；胰岛素抵抗 [中图法分类号] [文献标志码]A The effect of metabolic surgery on body mass index, insulin resistance and lipid in non-obese patients with type 2 diabetes Sun Fang1, Yan Zhencheng1, Chen Jing1, Ni Yinxing1, Gao Yu2, Tong Weidong2 ，Zhu Zhiming1 (1Center for Hypertension and Metabolic Diseases, Department of Hypertension and Endocrinology, 2Department of Gastric Colorectal Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing , 400042, China) [Abstract] Objective To compare the different overall effect of metabolic surgery on body mass index and metabolic indicators of obese or non-obese type 2 diabetes. Methods The body mass index 28 as the cutoff point, divided into obese diabetic group (BMI≥28, n = 10) and non-obese diabetic group (BMI28, n = 10), before the operation, calculate the ratio of the basic information, after the operation for 3-6 months, followed-up body mass index, glucose tolerance and insulin release, uric acid, total cholesterol, LDL cholesterol levels, and through the statistical analysis, to find the differences before and after surgery in each group, and compare the postoperative effects between the two groups. Results Correlation analysis showed that in non