Laparoscopic adjustable gastric banding and progression from impaired fasting glucose to diabetes

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• 作者：John M. Wentworth (1) (2)
  Tamishta Hensman (1)
  Julie Playfair (1)
  Cheryl Laurie (1)
  Matthew E. Ritchie (2) (3)
  Wendy A. Brown (1)
  Stewart Skinner (1)
  Jonathan E. Shaw (4)
  Paul E. O’Brien (1)
  
• 关键词：Bariatric surgery ; Diabetes prevention ; Impaired fasting glucose ; Obesity
• 刊名：Diabetologia
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：57
• 期：3
• 页码：463-468
• 全文大小：194 KB
• 作者单位：John M. Wentworth (1) (2)
  Tamishta Hensman (1)
  Julie Playfair (1)
  Cheryl Laurie (1)
  Matthew E. Ritchie (2) (3)
  Wendy A. Brown (1)
  Stewart Skinner (1)
  Jonathan E. Shaw (4)
  Paul E. O’Brien (1)
  
  1. Centre for Obesity Research and Education (CORE), Monash University at The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
  2. Molecular Medicine Division, Walter and Eliza Hall Institute, Parkville, Melbourne, VIC, Australia
  3. Department of Mathematics and Statistics, The University of Melbourne, Parkville, Melbourne, VIC, Australia
  4. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
  
• ISSN：1432-0428

文摘

Aims/hypothesis Obesity and dysglycaemia are major risk factors for type 2 diabetes. We determined if obese people undergoing laparoscopic adjustable gastric banding (LAGB) had a reduced risk of progressing from impaired fasting glucose (IFG) to diabetes. Methods This was a retrospective cohort study of obese people with IFG who underwent LAGB. Weight and diabetes outcomes after a minimum follow-up period of 4?years (mean ± SD 6.1?±-.7?years) were compared with those of Australian adults with IFG from a population-based study (AusDiab). Results We identified 281 LAGB patients with baseline IFG. Their mean ± SD age and BMI were 46?±-?years and 46?±-?kg/m2, respectively. The diabetes incidence for patients in the lowest, middle and highest weight loss tertile were 19.1, 3.4 and 1.8 cases/1,000?person-years, respectively. The AusDiab cohort had a lower BMI (28?±-?kg/m2) and a diabetes incidence of 12.5 cases/1,000?person-years. This increased to 20.5 cases/1,000?person-years when analysis was restricted to the 322 obese AusDiab participants, which was higher than the overall rate of 8.2 cases/1,000?person-years seen in the LAGB group (p--.02). Multivariable analysis of the combined LAGB and AusDiab data suggested that LAGB was associated with ?5% lower risk of diabetes (OR 0.24 [95% CI 0.10, 0.57], p--.004). Conclusions/interpretation In obese people with IFG, weight loss after LAGB is associated with a substantially reduced risk of progressing to diabetes over ??years. Bariatric surgery may be an effective diabetes prevention strategy in this population.