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首页> 外文期刊>Obesity surgery >Comparison of metabolic effects of surgical-induced massive weight loss in patients with long-term remission versus non-remission of type 2 diabetes
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Comparison of metabolic effects of surgical-induced massive weight loss in patients with long-term remission versus non-remission of type 2 diabetes

机译：长期缓解和不缓解2型糖尿病患者手术引起的大量体重减轻的代谢作用比较

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Background: The aim of this study was to evaluate the pathophysiological mechanisms underlying the non-remission of type 2 diabetes in Roux-en-Y gastric bypass (RYGB) patients. Methods: A group of patients not in remission (NR) was formed (n=13). A remission group (R) was composed of patients who had undergone normalization of fasting glycemia and A1c, without anti-diabetic drugs and matched for selected baseline characteristics (i.e., duration of disease, previous BMI, final BMI, fat distribution, and age; n=15). A control group of lean subjects (n=41) was formed. Results: The NR group had higher uric acid (5.1 vs. 3.9 mg/dL), number of leukocytes (6,866.9 vs. 5,423.6), hs-CRP (0.27 vs. 0.12 mg/dL), MCP-1 (118.4 vs. 64.4 ng/mL), HOMA-IR, and AUC glucose but lower adiponectin (9.4 vs. 15.4 ng/mL), leptin (12.7 vs. 20.7 ng/mL), and AUC GLP-1 in comparison to R group; the NR group also had lower leptin and higher adiponectin, HOMA-IR, AUC glucose, AUC C-peptide, AUC glucagon, and AUC GLP-1 than controls. The R group had lower MCP-1 and higher adiponectin compared to controls. Insulin sensitivity was significantly lower in the NR group than in the R and control groups. The insulin secretion index values were lower in the NR group than in the R and control groups. Conclusions: This study found greater insulin resistance, lower insulin secretion, persistent adiposopathy and chronic subclinical inflammation, and less robust incretin response in the NR group despite a similar level of weight loss. Persistently altered pathophysiological mechanisms can be related to the lack of remission of type 2 diabetes after RYGB.
机译：背景：本研究的目的是评估Roux-en-Y胃旁路（RYGB）患者未缓解2型糖尿病的病理生理机制。方法：形成一组未缓解的患者（NR）（n = 13）。缓解组（R）由接受了空腹血糖和A1c正常化，无抗糖尿病药且符合所选基线特征（即病程，既往BMI，最终BMI，脂肪分布和年龄）的患者组成。 n = 15）。形成一个瘦人对照组（n = 41）。结果：NR组的尿酸含量更高（5.1 vs. 3.9 mg / dL），白细胞数量（6,866.9 vs. 5,423.6），hs-CRP（0.27 vs.0.12 mg / dL），MCP-1（118.4 vs. 64.4） ng / mL），HOMA-IR和AUC葡萄糖，但与R组相比，脂联素（9.4 vs.15.4 ng / mL），瘦素（12.7 vs.20.7 ng / mL）和AUC GLP-1更低; NR组的瘦素和脂联素，HOMA-IR，AUC葡萄糖，AUC C肽，AUC胰高血糖素和AUC GLP-1也较低。与对照组相比，R组具有较低的MCP-1和较高的脂联素。 NR组的胰岛素敏感性明显低于R和对照组。 NR组的胰岛素分泌指数值低于R组和对照组。结论：这项研究发现，尽管体重减轻水平相似，但NR组的胰岛素抵抗更大，胰岛素分泌减少，持续性脂肪病和慢性亚临床炎症，肠降血糖素反应减弱。持续改变的病理生理机制可能与RYGB后2型糖尿病缺乏缓解有关。

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