河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (2): 177-182.doi: 10.3969/j.issn.1007-3205.2025.02.009

• • 上一篇    下一篇

腹腔镜袖状胃切除术对2型糖尿病肥胖患者长期维持减重效应和血糖稳态的影响分析

  

  1. 江苏省南京市江宁医院内分泌科，江苏 南京 211100

  • 出版日期:2025-02-25 发布日期:2025-02-27
  • 作者简介:黄丹（1977-），女，吉林通化人，江苏省南京市江宁医院副主任医师，医学硕士，从事肥胖与肥胖相关并发症诊治研究。
  • 基金资助:
    江苏省卫健委医学科研项目(ZD2021012)

Analysis of the impact of laparoscopic sleeve gastrectomy on long-term weight loss maintenance and glycemic stability in patients with type 2 diabetes mellitus and obesity

  1. Department of Endocrinology, Jiangning Hospital of Nanjing, Jiangsu Province, Nanjing 211100, China

  • Online:2025-02-25 Published:2025-02-27

HTML

PDF (PC)

146

摘要： 目的 研究腹腔镜袖状胃切除术对2型糖尿病肥胖患者在长期维持减重效应和血糖稳态的影响，以及减重情况和血糖稳态的关系探讨。
方法 选取在江苏省南京市江宁医院诊断为肥胖的80例2型糖尿病患者为研究对象，均实施腹腔镜袖状胃切除术。对比患者术前和术后2年内各随访时间点的体重、体重指数（body mass index,BMI）、腰围；比较患者手术前后的血糖谱［糖化血红蛋白（glycated hemoglobin,HbA1c）、空腹血糖（fasting plasma glucose,FPG）、餐后2 h血糖（2-hour postprandial blood glucose,2 hPBG）］、HOMA模型参数［胰岛β细胞功能指数(homeostatic model assessment of beta-cell function,HOMA-β)、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)］、胰岛素分泌指数（△I10/△G10）以及甲状腺功能指标［甲状腺刺激激素(thyroid-stimulating hormone,TSH)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)］，并根据结果做各指标间的相关性分析。
结果 患者在干预后的2年内体重、腰围、BMI和血糖指标在各随访时间点均较术前显著下降，术后HOMA-β和胰岛素分泌指数显著高于术前，HOMA-IR低于术前，且术后患者的TSH值下降，而FT3和FT4则持续上升，差异均有统计学意义（均P＜0.05）。相关性分析显示，患者的BMI与血糖指标及甲状腺激素水平呈正相关，与胰岛素分泌指数呈负相关（P＜0.05）。 
结论 对于2型糖尿病肥胖患者，血糖、胰岛素和甲状腺指标均会影响其体重和腰围，应用腹腔镜袖状胃切除术有助于维持减重效果、改善血糖稳态，为患者提供了一个更可靠的治疗手段。


关键词: 糖尿病, 2型, 肥胖, 血糖稳态

Abstract: Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG) on long-term weight loss maintenance and glycemic stability in patients with type 2 diabetes mellitus (T2DM) and obesity, and to explore the relationship between weight loss and glycemic stability. 
Methods A total of 80 T2DM patients diagnosed with obesity in Jiangning Hospital of Nanjing City, Jiangsu Province, were selected as the research subjects, and underwent LSG. Body weight, body mass index (BMI), and waist circumference of the patients were compared before surgery and at various follow-up points within two years after the surgery. The glycemic profile ［glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2 hPBG)］, HOMA model parameters ［homeostatic model assessment of β-cell function (HOMA-β), homeostatic model assessment of insulin resistance (HOMA-IR)］, insulin secretion index (△I10/△G10), and thyroid function indicators ［thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4)］ before and after surgery were compared before and after surgery. Correlation analysis was performed based on the results between various indicators. 
Results At various follow-up points within two years after intervention, body weight, waist circumference, BMI and blood glucose indexes were significantly lower than those before surgery, the postoperative HOMA-β and insulin secretion index were significantly higher than those before operation, the HOMA-IR was lower than that before surgery, and the TSH value of postoperative patients decreased significantly, while FT3 and FT4 showed a continuous upward trend, suggesting significant differences (all P＜0.05). Correlation analysis showed that BMI was positively correlated with blood glucose index and thyroid hormone level, and negatively correlated with insulin secretion index (P＜0.05). 
Conclusion For patients with obesity and T2DM, blood glucose, insulin, and thyroid indicators all affect their weight and waist circumference. The application of LSG helps to maintain weight loss effects and improve glycemic stability, providing a more reliable treatment option for patients. 


Key words: diabetes mellitus, type 2, obesity, glycemic stability

版权所有 © 《河北医科大学学报》编辑部
本系统由北京玛格泰克科技发展有限公司设计开发