亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Bariatric Surgery for Weight Loss and Glycemic Control in Nonmorbidly Obese Adults With Diabetes

医学 血糖性 减肥 体质指数 糖尿病 随机对照试验 2型糖尿病 外科 科克伦图书馆 肥胖 观察研究 内科学 内分泌学
作者
Melinda Maggard-Gibbons,Margaret Maglione,Masha J. Livhits,Brett Ewing,Alicia Ruelaz Maher,Jianhui Hu,Zhaoping Li,Paul G Shekelle
出处
期刊:JAMA [American Medical Association]
卷期号:309 (21): 2250-2250 被引量:211
标识
DOI:10.1001/jama.2013.4851
摘要

Importance

Bariatric surgery is beneficial in persons with a body mass index (BMI) of 35 or greater with obesity-related comorbidities. There is interest in using these procedures in persons with lower BMI and diabetes.

Objective

To assess the association between bariatric surgery vs nonsurgical treatments and weight loss and glycemic control among patients with diabetes or impaired glucose tolerance and BMI of 30 to 35.

Evidence Review

PubMed, EMBASE, and Cochrane Library databases were searched from January 1985 through September 2012. Of 1291 screened articles, we included 32 surgical studies, 11 systematic reviews on nonsurgical treatments, and 11 large nonsurgical studies published after those reviews. Weight loss, metabolic outcomes, and adverse events were abstracted by 2 independent reviewers.

Findings

Three randomized clinical trials (RCTs) (N = 290; including 1 trial of 150 patients with type 2 diabetes and mean BMI of 37, 1 trial of 80 patients without diabetes [38% with metabolic syndrome] and BMI of 30 to 35, and 1 trial of 60 patients with diabetes and BMI of 30 to 40 [13 patients with BMI <35]) found that surgery was associated with greater weight loss (range, 14.4-24 kg) and glycemic control (range, 0.9-1.43 point improvements in hemoglobin A1c levels) during 1 to 2 years of follow-up than nonsurgical treatment. Indirect comparisons of evidence from observational studies of bariatric procedures (n ≈ 600 patients) and meta-analyses of nonsurgical therapies (containing more than 300 RCTs) support this finding at 1 or 2 years of follow-up. However, there are no robust surgical data beyond 5 years of follow-up on outcomes of diabetes, glucose control, or macrovascular and microvascular outcomes. In contrast, some RCT data of nonsurgical therapies show benefits at 10 years of follow-up or more. Surgeon-reported adverse events were low (eg, hospital deaths of 0.3%-1.0%), but data were from select centers and surgeons. Long-term adverse events are unknown.

Conclusions and Relevance

Current evidence suggests that, when compared with nonsurgical treatments, bariatric surgical procedures in patients with a BMI of 30 to 35 and diabetes are associated with greater short-term weight loss and better intermediate glucose outcomes. Evidence is insufficient to reach conclusions about the appropriate use of bariatric surgery in this population until more data are available about long-term outcomes and complications of surgery.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
科研通AI2S应助HeHe采纳,获得10
42秒前
WerWu完成签到,获得积分10
1分钟前
1分钟前
2分钟前
2分钟前
清爽幼枫发布了新的文献求助10
2分钟前
852应助phentjn采纳,获得30
2分钟前
Owen应助zhaojing9532采纳,获得10
3分钟前
3分钟前
lya完成签到 ,获得积分10
3分钟前
3分钟前
3分钟前
默默的访旋完成签到,获得积分10
4分钟前
bkagyin应助小不点、大迷糊采纳,获得10
4分钟前
4分钟前
4分钟前
4分钟前
zhaojing9532完成签到,获得积分10
4分钟前
zhaojing9532发布了新的文献求助10
4分钟前
酷炫的小紫完成签到,获得积分10
5分钟前
rocky15应助shenlee采纳,获得10
5分钟前
爆米花应助xing采纳,获得10
5分钟前
欧皇完成签到,获得积分10
5分钟前
5分钟前
phentjn发布了新的文献求助30
5分钟前
科研通AI2S应助zhaojing9532采纳,获得10
5分钟前
英姑应助phentjn采纳,获得30
5分钟前
6分钟前
rocky15应助Rin采纳,获得10
6分钟前
xiaowang完成签到 ,获得积分10
6分钟前
千倾完成签到 ,获得积分10
6分钟前
脑洞疼应助a123采纳,获得30
6分钟前
6分钟前
6分钟前
7分钟前
xing发布了新的文献求助10
7分钟前
sdfzaq1发布了新的文献求助100
7分钟前
xing完成签到,获得积分10
7分钟前
7分钟前
7分钟前
高分求助中
Un calendrier babylonien des travaux, des signes et des mois: Séries iqqur îpuš 1036
Sustainable Land Management: Strategies to Cope with the Marginalisation of Agriculture 1000
Corrosion and Oxygen Control 600
Heterocyclic Stilbene and Bibenzyl Derivatives in Liverworts: Distribution, Structures, Total Synthesis and Biological Activity 500
重庆市新能源汽车产业大数据招商指南(两链两图两池两库两平台两清单两报告) 400
Division and square root. Digit-recurrence algorithms and implementations 400
行動データの計算論モデリング 強化学習モデルを例として 400
热门求助领域 (近24小时)
化学 材料科学 医学 生物 有机化学 工程类 生物化学 纳米技术 物理 内科学 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 电极 光电子学 量子力学
热门帖子
关注 科研通微信公众号,转发送积分 2545431
求助须知:如何正确求助?哪些是违规求助? 2175634
关于积分的说明 5600159
捐赠科研通 1896337
什么是DOI,文献DOI怎么找? 946226
版权声明 565355
科研通“疑难数据库(出版商)”最低求助积分说明 503552