| Objective Tosystematically evaluate the efficacies of three common reconstructions of digestive tract(Billroth??Billroth??Roux-en-Y gastric bypass)for the treatment of non-obese(BMI<30kg/m2)type 2 diabetes mellitus patients with or without gastric cancerMethods A comprehensive search of the Cochrane library,Pubmed,Spinger Link,CBM,CNKI and Wan Fang databases of published articles from database establishment to December 2015 was performed and reference lists of relevant articles was also reviewed.The Stata 13.0 software was used for meta-analysis.Results Twenty studies including 83 Billroth?cases,217 Billroth?cases and 656Roux-en-Y gastric bypass cases were enrolled and analyzed.The meta-analysis showed that three reconstructions led to an overall 2.29kg/m2(WMD=2.29,95%CI:1.36~3.22,p=0.000)reduction in BMI,a 3.13mmol/L(WMD=3.13,95%CI:2.43~3.84,p=0.000)reduction in FBG,a 1.83(WMD=1.83,95%CI:1.44~2.22,p=0.000)reduction in Hb A1 c,a 1.68(WMD=1.68,95%CI:1.10~2.26,p=0.000)reduction in HOMA-IR,a 0.7mmol/L(WMD=0.7,95%CI:0.23~1.16,p=0.000)reduction in TC compared with the preoperation.Subgroup analyses showed that in the subgroup with Billroth?reconstruction,the pooled BMI reduction(WMD=1.73,95%CI :-0.36-3.82),FBG reduction(WMD=0.98,95%CI:-0.14-2.10),Hb A1 c reduction(WMD=0.37,95%CI:-0.07-0.80)and operation efficacy rate(0.19,95%CI:0-0.56) were all inferior to Billroth ?and RYGB,and the changes of Billroth?before and after surgery showed no statistical significance.Billroth?was superior to RYGB in BMI reduction(Billroth??:WMD=3.14,95%CI:2.46-3.81,RYGB:WMD=2.29,95%CI:1.06-3.52),but in the reduction of FBG,Hb A1 c and operation efficacy rate was inferior to RYGB.In the subgroup with gastric cancer,the pooled BMI,FBG,Hb A1 c,HOMA-IR were all reduced significantly except TC,all of which were inferior to those without gastric cancer.Conclusions RYGB reconstruction might improve glycemic control and weight loss to some extent for non-obese T2 DM patients with BMI<30kg/m2... |
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