期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 106, 期 3, 页码 922-933出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgaa737
关键词
Roux-en-Y gastric bypass; sleeve gastrectomy; type 2 diabetes; remission; lifestyle; meta-analysis
This study compared the efficacy of RYGB and SG for T2D remission and found that RYGB had a higher chance of achieving remission at 1 year compared to SG, while only showing a significant difference in achieving broad criteria for remission at 5 years. No other differences were found between the two procedures.
Context: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the bariatric procedures most commonly used for the management of obesity. Whether one or the other is associated with a higher chance of remission of type 2 diabetes (T2D) is unclear. Objective: This work aims to compare the efficacy of RYGB and SG for T2D remission at 1, 3, and 5 years after surgery. Data Sources: Four databases were searched until January 2020. Study Selection: Randomized controlled studies with at least 12 months of follow-up of patients with T2D allocated to RYGB or SG were selected. Data Extraction: To ensure uniformity, broad and narrow criteria for T2D remission were defined. The number of patients achieving remission of T2D at each assessment was extracted. Data were pooled using a random-effects model. Data Synthesis: Ten studies were included, evaluating 778 patients. The overall prevalence of achievement of broad and narrow criteria for T2D remission was 73% and 53% at the 1-year, 60% and 48% at the 3-year, and 51% and 43% at the 5-year assessment. Compared to SG, RYGB was associated with a higher chance of achieving broad and narrow criteria for remission at 1 year after surgery (risk ratio [RR]=1.34 vs RR=1.22) and broad criteria for remission at 5 years (RR=1.18). No other differences were found. Conclusions: The present meta-analysis suggests a more favorable effect of RYGB than SG on achieving T2D remission in the short-term only, although the evidence currently available does not clarify whether differences in this outcome are confirmed long term or fade thereafter.
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