| Background:The morbidity of Diabetes and Obesity is increasing with each passing year and complications is a serious threat to human health.In controlling glucose and loss weight and to prevent the complications,medical therapy may have a short-term effective?Patients' quality of life is poor and suffering from Diabetes or fat or their complications.In recent research,laparoscopic bariatric surgery(LBS)is an effective method which either can anti-obesity or can treat Type 2 Diabetes successfully.There is a large number of researches on obesity with diabetes after bariatric surgery.However,few study are reported on Chinese type 2 diabetes mellitus with obesity under surgical procedures.Objective:To observe the clinical effect of LBS in short-term on type 2 diabetes mellitus with obesity in Chinese people.To compare the difference between the LGBP and LSG.Method: 23 patients were T2 DM with obesity undergoing Laparoscopic Gastric bypassu(LGBP)and Laparoscopic Sleeve Gastrectomy(LSG)in the first hospital affiliated to Dalian Medical university from February 2015 to November.To compare the change in the level of weight(W),waist circumference(WC),Body Mass Index(BMI),extra weight loss percentage(EWL%),extra BMI loss percentage(EBMIL%),glycosylated hemoglobin(Hb A1c),fasting plasma glucose(FPG),2hours plasma glucose after 75 g oral glucose tolerance test(2h PG),fasting C peptide(CP),2 hours CP after 75 g oral glucose tolerance test(2h CP),the ratio of C2/C0,homeostasis model assessment-insulin resistance index(HOMA-IR),liver function,renal function,eleclxolytes,blood routine three months after LBS.To observe the remission of T2 DM and the complication occurrence after LBS.Result:1.21 patients were follow-up and 2 patients were lost to follow-up three months later.The total levels of W(cm),WC(cm),BMI(kg/m2)were obviously decreased after LBS [75.5±14.9 VS 91.7±16.6 p<0.01 ? 86.8±9.4 VS 103.7±14.1p<0.01 ? 24.5(23.1,27.9)VS 30.1(28.5,33.2)p<0.01].The total levels of FPG(mmol/L),2h PG(mmol/L),Hb A1c(%)were obviously decreased after LBS(6.1±2.2 VS 9.2±3.7 p<0.01?8.2±6.2 VS 17.6±5.6 p<0.01?6.5±1.4 VS 8.4±2.1p<0.01).The level of HOMA-IR decreased after LBS(2.4±0.3 VS 3.4±1.5 p<0.05).The level of EWL(%),(EBMIL%)was significantly higher in LGBP group than in LSG group[79±29 VS 50(27,61)p<0.05?109.1±50.0 VS 60.2(30.3,70.1)p<0.05].2.The total effective rate was 95.2%(20),The remission and effective rate of T2 DM were respectively 64.7%(11),94.1%(16)in group LGBP and 75%(3),100%(4)in group LSG and the difference was not significant[remission:64.7%(11)VS 75%(3),improve:29.4%(5)VS 25%(1),ineffective:5.9%(1)VS 0%(0)p>0.05].The total side effect rate of LBS 12.5%(3)and there was no difference between the two group(17.6% VS 0 p>0.05).3.There was a significantly decline in total triglyceride(TG)(mmol/L)(1.1±0.3VS 1.7 ± 0.9 p<0.05).The level of high density lipoprotein cholesterol(HDL-C)(mmol/L),low density lipoprotein cholesterol(LDL-C)(mmol/L)and total cholesterol(TC)(mmol/L)were not changed(1.3±0.3 VS 1.7±0.9 p>0.05?2.4±0.5 VS2.7±0.9 p>0.05 ? 4.4±0.6 VS 4.8±1.2 p>0.05).The level of ?-glutamyltransferase(?GT)(U/L)were decreased(22.1±13.8 VS 41.1 ± 45.6 p<0.05)and the level of alanine aminotranceferase(ALT)(g/L),aspertate aminotransferase(AST)(g/L)and alkaline phosphatase(ALP)(U/L)were not changed(19.6±9.7 VS 28.6±17.6 p>0.05?17.3±9.4 VS 20.2±10.3 p>0.05?70.7±22.4 VS 75.7±20.8 p>0.05).The decrease in cretinine(Cre)(umol/L)and urea acid(UA)(umol/L)was not obvious three months after LBS(53.3±14.5 VS 51.9±12.4 p>0.05?335.8±98.9 VS 349.7±95.6 p>0.05).Conclusion : 1.LBS could successfully loss one's weight and improve their glucose metabolic disorders and decrease insulin-resistance in Chinese T2 DM with Obesity in short-term.Part of patients with T2 DM can be cured and LBS is safe.2.The improvement of dyslipidemia and the decrease in the level of liver enzyme happened after LBS which cannot decline the level of UA.3.The clinical effect of LGBP in losing weight is superior to LSG. |
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