Early postoperative insulin-resistance changes after sleeve gastrectomy with ileal interposition duodenojejunal bypass operation
10.3760/cma.j.issn.1674-6090.2013.03.009
- VernacularTitle:袖状胃切除间置回肠的十二指肠空肠旁路术后早期胰岛素抵抗的变化
- Author:
Yinghong YANG
;
Yanjun WU
;
Jing YAN
;
Yuan LIN
;
Xiaolin YUE
- Publication Type:Journal Article
- Keywords:
Type 2 diabetes mellitus;
Sleeve gastrectomy;
Ileal interposition;
Duodenojejunal bypass;
Insulin resistance
- From:Journal of Endocrine Surgery
2013;7(3):209-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the early effects on insulin resistance following sleeve gastrectomy with ileal interposition duodenojejunal bypass operation.Methods From Jun.2010 to Sep.2011,37 cases of type 2 diabetes mellitus patients [23 male,14 female; mean age (45.2 ± 2.4) years,mean BMI (21.7 ± 1.8) kg/m2] underwent sleeve gastrectomy with ileal interposition duodenojejunal bypass operation.Fasting plasma glucose(FPG),fasting insulin(FIns),body mass index(BMI),and homeostatic model assessment for insulin resistance (HOMAIR) were detected before surgery and on the 10th,20th,30th,and 60th day after surgery.Results The level of FPG was (6.8 ± 0.7) mmol/L,(7.2 ± 0.6) mmol/L,(6.9 ± 0.3) mmol/L respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery[(10.2 ±0.4)mmol/L].The difference had statistical significance (P ＜ 0.05).The level of Fins was (6.3 ± 1.1) mIu/L,(7.1 ± 1.3) mIu/L,and (7.3 ± 1.6) mIu/L respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery[(12.6 ± 1.4)mIu/L].The difference had statistical significance (P ＜ 0.05).The level of lnHOMA-IR was 0.7 ± 0.2,0.9 ± 0.5,and 0.8 ±0.4 respectively on the 10th,20th,and 30th day after surgery,significantly lower than that before surgery (1.8 ±0.6).The differenc had statistical significance(P ＜0.05).However,the change of BMI was not obvious between before surgery and on the 10th,20th,and 30th day after surgery.The difference had no statistical significance (P ＞ 0.05).on the 60th day after surgery,the level of FPG,Fins,lnHOMA-IR and BMI was significantly reduced compared with that before surgery.The difference had statistical significantce(P ＜0.05).Conclusion After sleeve gastrectomy with ileal interposition duodenojejunal bypass operation,the early improvement of insulin resistance occurs rapidly and it is iadependent of the loss of BMI.
