【摘 要】
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Baekground: Morbid obese patients with type 2 diabetes mellitus (T2DM) and a body mass index(BMI) >35 kg/m2 benefit greatly from Roux-en-Y gastric bypass surgery (RYGB).Whether the patients with T2DM
【机 构】
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Cardiovascular Medicine Min-Sheng General Hospital Taiwan
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Baekground: Morbid obese patients with type 2 diabetes mellitus (T2DM) and a body mass index(BMI) >35 kg/m2 benefit greatly from Roux-en-Y gastric bypass surgery (RYGB).Whether the patients with T2DM and a body mass index (BMI)<35kg/m2 also profit from this surgical procedure is not known.We examined the safety and efficacy of RYGB and 10 year risk for cerebral and cardiovascular disease with UKPDS riskengine in Asian Taiwanese patients with T2DM and a BMI of 22-35 kg/rn2 in a tertiary care referral medical center.Methods: A total 47 consecutive patients with T2DM and a BMI of 24-35kg/m2 underwent RYGB between 2003 and 2009.The data were prospectively collective before surgery and at 3, 6 and 12 months after operation.Results: Of the 47 patients, 8 were men and 39 were women (age 40.70 ± 1.56 years old).Their preoperative characteristics were BMI 30.54 ± 0.40 kg/m2, waist circumference 100.05 ± 1.31 cm, and duration of T2DM 6.06 ± 0.73 years.There was no mortality, major surgical morbidity, or excessive weight loss experienced.The BMI level, fasting blood glucose level, hemoglobin A1 c, waist circumference, presence of dyslipidemia, and hypertension improved significantly.The 10-year cerebral and cardiovascular disease risk was estimated in using the UKPDS risk engine before and after RYGB.The risk for fatal and nonfatal coronary heart disease decreased essentially but fatal and nonfatal stroke just decreased not evenly.Conclusion: RYGB safely and effectively remits T2DM in Asian Taiwanese with a BMI <35 kg/m2.It also lessens the 10-year cardiovascular disease risk.The 10-year cerebral vascular disease risk does not reduce obviously.More larger, longer term, prospective and randomized studies are needed to confirm these effects.
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