Role of Gastrointestinal Hormones as a Predictive Factor for Long-Term Diabetes Remission: Randomized Trial Comparing Metabolic Gastric Bypass, Sleeve Gastrectomy, and Greater Curvature Plication.

Bariatric surgery Diabetes remission Greater curvature plication Metabolic gastric bypass Obesity Sleeve Type 2 diabetes mellitus

Journal

Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714

Informations de publication

Date de publication:
04 2021
Historique:
received: 18 09 2020
accepted: 21 12 2020
revised: 11 12 2020
pubmed: 6 1 2021
medline: 20 4 2021
entrez: 5 1 2021
Statut: ppublish

Résumé

Long-term studies comparing the mechanisms of different bariatric techniques for T2DM remission are scarce. We aimed to compare type 2 diabetes (T2DM) remission after a gastric bypass with a 200-cm biliopancreatic limb (mRYGB), sleeve gastrectomy (SG), and greater curvature plication (GCP), and to assess if the initial secretion of gastrointestinal hormones may predict metabolic outcomes at 5 years. Forty-five patients with mean BMI of 39.4(1.9)kg/m Total weight loss percentage (TWL%) at year 1 and GLP-1 AUC at months 1 and 12 were higher in the mRYGB than in the SG and GCP. TWL% remained greater at 5 years in mRYGB group - 27.32 (7.8) vs. SG - 18.00 (10.6) and GCP - 14.83 (7.8), p = 0.001. At 5 years, complete T2DM remission was observed in 46.7% after mRYGB vs. 20.0% after SG and 6.6% after GCP, p < 0.001. In the multivariate analysis, shorter T2DM duration (OR 0.186), p = 0.008, and the GLP-1 AUC at 1 month (OR 7.229), p = 0.023, were prognostic factors for complete T2DM remission at 5-year follow-up. Long-term T2DM remission is mostly achieved with hypoabsortive techniques such as mRYGB. Increased secretion of GLP-1 after surgery and shorter disease duration were the main predictors of T2DM remission at 5 years.

Identifiants

pubmed: 33398627
doi: 10.1007/s11695-020-05192-x
pii: 10.1007/s11695-020-05192-x
doi:

Substances chimiques

Gastrointestinal Hormones 0

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1733-1744

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Auteurs

Anna Casajoana (A)

Department of General and Gastrointestinal Surgery, Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Fernando Guerrero-Pérez (F)

Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Amador García Ruiz de Gordejuela (A)

Department of General Surgery, Endocrine, Bariatric and Metabolic Surgery Unit, Vall d'Hebron University Hospital, Ps Vall d'Hebron, 119-129, 08035, Barcelona, Spain.

Víctor Admella (V)

Department of General and Gastrointestinal Surgery, Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Maria Sorribas (M)

Department of General and Gastrointestinal Surgery, Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Anna Vidal-Alabró (A)

Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Núria Virgili (N)

Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Rafael López Urdiales (RL)

Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Mónica Montserrat (M)

Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Manuel Pérez-Maraver (M)

Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Carme Monasterio (C)

Department of Pneumology, Sleep Unit, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Neus Salord (N)

Department of Pneumology, Sleep Unit, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Silvia Pellitero (S)

Department of Endocrinology and Nutrition and Health Sciences Research Institute, University Hospital Germans Trias i Pujol, Badalona, Spain.

Sonia Fernández-Veledo (S)

Diabetes and Metabolic Associated Diseases Research Group, Hospital Universitari Joan XXIII-Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain.
CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.

Joan Vendrell (J)

Diabetes and Metabolic Associated Diseases Research Group, Hospital Universitari Joan XXIII-Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain.
CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.
School of Medicine, Universitat Rovira i Virgili, Tarragona, Spain.

Jordi Pujol Gebelli (JP)

Department of General and Gastrointestinal Surgery, Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.

Núria Vilarrasa (N)

Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. nuriavilarrasa@yahoo.es.
CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain. nuriavilarrasa@yahoo.es.

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