Fellow-up And Analysis Of Bariatric Surgery In Patients With Obesity And Type 2 Diabetes Mellitus

Background:With the development of economy and the improvement of people's living standard,the incidence of obesity and type 2 diabetes mellitus is growing.In recent years,bariatric surgery has been accepted as a new therapy and applied internationally.In China,bariatric surgery started rather late,the number of surgery and the follow-up data is also relatively small.Objective:To investigate the effects of bariatric surgery in patients with obesity and type 2 diabetes mellitus in three years after surgery,and analyse the data of body weight,metabolism index,nutrition condition and quality of life,to improve the understanding of bariatric surgery.Methods:We retrospectively analyse the clinical data of 20 patients underwent bariatric surgery in Jiahe Surgical Hospital from Apr.2012 to Apr.2015,the clinical parameters such as body weight,waist circumference,BMI,fasting and 2-hour postprandial blood glucose,hemoglobin,fasting and 2-hour postprandial C-peptide,fasting and 2-hour postprandial insulin,ratio of 2-hour postprandial to fasting C-peptide were evaluated before and at the sixth month,the first year and the third year after surgery.Vitamin B12,vitamin D,vitamin E,folic acid,iron metabolism,trace elements,and the total cholesterol,triglycerides,low-density lipoprotein cholesterol were investigated at the third year after surgery.The quality of life was investigated and compared with the control group.Results:1.Body weight,waist circumference,body mass index decreased significantly in six months,the first year and the third year after surgery(P < 0.001).The decrease was most obvious in six months after surgery,and the index rebound at the third year(P < 0.05),but it was still better than baseline(P < 0.05).2.Hemoglobin,fasting and 2-hour postprandial blood glucose,fasting and 2-hour postprandial insulin decreased,C2/C0 rised in six months and the first year after surgery(P < 0.05),the changes of hemoglobin,fasting and 2-hour postprandial blood glucose were significant(P < 0.001),and the main change is also within the six months.Fasting and 2-hour postprandial C-peptide decreased at the first year and the third year after operation(P < 0.05).The related indexes rebounded at the third year(P < 0.05),but still better than baseline(P < 0.05).3.Triglyceride,total cholesterol and low-density lipoprotein cholesterol in patients with dyslipidemia were significantly decreased(P < 0.001),and the systolic pressure and diastolic pressure decreased significantly in patients with poor blood pressure control(P < 0.001).4.100% patients lack vitamin D,50% have calcium deficiency,20% lack vitamin B12,20% have iron deficiency,and 15% suffer anemia at the third year after operation,there was no obvious abnormality in other vitamins and microelements.5.Compared with the control group,the quality of life in the operation group patients was higher,especially in the physical function,bodily pain and genenal health(P < 0.05).Conclusions:1.The body weight,blood glucose and islet function of the patients were significantly improved after bariatric surgery,and the index changed mainly in six months after the operation,but there would be a rebound at the third year after operation.2.Some patients may suffer anemia,calcium deficiency,iron deficiency,vitamin D and vitamin B12 deficiency after 3 years.3.The operation can obviously improve the quality of life of the patients,and it is mainly in physical health.