https://scholars.lib.ntu.edu.tw/handle/123456789/495576
標題: | Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes | 作者: | Dixon J.B. LEE-MING CHUANG Chong K. Chen S.-C. Lambert G.W. Straznicky N.E. Lambert E.A. Lee W.-J. |
公開日期: | 2013 | 卷: | 36 | 期: | 1 | 起(迄)頁: | 20-26 | 來源出版物: | Diabetes Care | 摘要: | OBJECTIVE - To find clinically meaningful preoperative predictors of diabetes remission and conversely inadequate glycemic control after gastric bypass surgery. Predicting the improvement in glycemic control in those with type 2 diabetes after bariatric surgery may help in patient selection. RESEARCH DESIGN AND METHODS - Preoperative details of 154 ethnic Chinese subjects with type 2 diabetes were examined for their influence on glycemic outcomes at 1 year after gastric bypass. Remission was defined as HbA1c ?6%. Analysis involved binary logistic regression to identify predictors and provide regression equations and receiver operating characteristic curves to determine clinically useful cutoff values. RESULTS - Remission was achieved in 107 subjects (69.5%) at 12 months. Diabetes duration <4 years, body mass >35 kg/m2, and fasting C-peptide concentration >2.9 ng/mL provided three independent preoperative predictors and three clinically useful cutoffs. The regression equation classification plot derived from continuous data correctly assigned 84% of participants. A combination of two or three of these predictors allows a sensitivity of 82% and specificity of 87% for remission. Duration of diabetes (with different cutoff points) and C-peptide also predicted those cases in which HbA1c ?7% was not attained. Percentage weight loss after surgery was also predictive of remission and of less satisfactory outcomes. CONCLUSIONS - The glycemic response to gastric bypass is related to BMI, duration of diabetes, fasting C-peptide (influenced by insulin resistance and residual β-cell function), and weight loss. These data support and refine previous findings in non-Asian populations. Specific ethnic and procedural regression equations and cutoff points may vary. ? 2013 by the American Diabetes Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84872019969&doi=10.2337%2fdc12-0779&partnerID=40&md5=4c770041212430572835f5f6933509d7 https://scholars.lib.ntu.edu.tw/handle/123456789/495576 |
ISSN: | 0149-5992 | DOI: | 10.2337/dc12-0779 | SDG/關鍵字: | C peptide; hemoglobin A1c; adult; article; bariatric surgery; body mass; cell function; clinical effectiveness; controlled clinical trial; controlled study; disease duration; female; glycemic control; human; insulin resistance; intermethod comparison; major clinical study; male; non insulin dependent diabetes mellitus; outcome assessment; pancreas islet beta cell; patient assessment; patient selection; prediction; preoperative evaluation; remission; sensitivity and specificity; stomach bypass; weight reduction; Adolescent; Adult; Aged; Aspartate Aminotransferases; Blood Glucose; C-Reactive Protein; Cholesterol, HDL; Diabetes Mellitus, Type 2; Female; Gastric Bypass; Hemoglobin A, Glycosylated; Humans; Longitudinal Studies; Male; Middle Aged; Triglycerides; Uric Acid; Young Adult |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。