PMID- 24857051
OWN - NLM
STAT- MEDLINE
DCOM- 20150803
LR  - 20221207
IS  - 1878-7533 (Electronic)
IS  - 1550-7289 (Linking)
VI  - 10
IP  - 5
DP  - 2014 Sep-Oct
TI  - Laparoscopic Roux-en-Y gastric bypass for nonobese type II diabetes mellitus in 
      Asian patients.
PG  - 834-40
LID - S1550-7289(14)00027-6 [pii]
LID - 10.1016/j.soard.2014.01.018 [doi]
AB  - BACKGROUND: The beneficial role of laparoscopic Roux-en-Y gastric bypass (LRYGB) 
      for type 2 diabetes mellitus (T2 DM) in morbidly obese patients has been 
      established; however, there is scant evidence supporting its effectiveness in 
      nonobese T2 DM Asian patients. The objective of this study was to evaluate the 
      effect of LRYGB in nonobese T2 DM patients and elucidate the predictors of DM 
      remission after one year follow-up. METHODS: Between June 2009 and May 2011, 
      twenty-nine nonobese (body mass index (BMI)<27 kg/m(2)) Asian patients with T2 DM 
      who underwent LRYGB were enrolled. All patients were prospectively followed up 
      for one year. Baseline demographic characteristics, diabetic status, and clinical 
      and biochemical data were collected preoperatively and one year after LRYGB. DM 
      remission was defined as those with hemoglobin A1 c (HbA1 c)<6.5% without oral 
      hypoglycemic drugs (OHA)/insulin. Outcomes in the DM remission group were 
      compared with the nonremission group and analyzed. RESULTS: All clinical and 
      biochemical parameters, except uric acid, were significantly improved. DM 
      remission was achieved in eleven patients (37.9%) of whom five (45.5%) were male. 
      Blood glucose, HbA1 c, c-peptide, homeostatic model assessment (HOMA-%B), and low 
      density lipoprotein (LDL)-cholesterol were the significant variables in patients 
      with DM remission; however, multiple logistic regression showed that only 
      preoperative HOMA-%B (odds ratio (OR) = 1.13, 95% CI = 1.03-1.24) was a predictor 
      for DM remission. Though no mortality was seen, the complication rate was 20.7%, 
      of which 17.3% was related to marginal ulcers. CONCLUSION: LRYGB resulted in 
      significant clinical and biochemical improvements in nonobese Asian patients, 
      with HOMA-%B indicating beta-cell function as the main predictor of T2 DM remission. 
      Appropriate patient selection with better beta-cell function and evidence from 
      long-term follow-up may justify this therapeutic approach.
CI  - Copyright (c) 2014 American Society for Bariatric Surgery. Published by Elsevier 
      Inc. All rights reserved.
FAU - Malapan, Kirubakaran
AU  - Malapan K
AD  - Bariatric and Metabolic International Surgery Centre, E-Da Hospital, Kaohsiung 
      City, 82445, Taiwan.
FAU - Goel, Rajat
AU  - Goel R
AD  - Bariatric and Metabolic International Surgery Centre, E-Da Hospital, Kaohsiung 
      City, 82445, Taiwan.
FAU - Tai, Chi-Ming
AU  - Tai CM
AD  - Bariatric and Metabolic International Surgery Centre, E-Da Hospital, Kaohsiung 
      City, 82445, Taiwan; Institute of Clinical Medicine, College of Medicine, 
      Kaohsiung Medical University, Kaohsiung, Taiwan.
FAU - Kao, Yu-Hsi
AU  - Kao YH
AD  - Bariatric and Metabolic International Surgery Centre, E-Da Hospital, Kaohsiung 
      City, 82445, Taiwan.
FAU - Chang, Po-Chih
AU  - Chang PC
AD  - Bariatric and Metabolic International Surgery Centre, E-Da Hospital, Kaohsiung 
      City, 82445, Taiwan.
FAU - Huang, Chih-Kun
AU  - Huang CK
AD  - Bariatric and Metabolic International Surgery Centre, E-Da Hospital, Kaohsiung 
      City, 82445, Taiwan. Electronic address: dr.ckhuang@hotmail.com.
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140128
PL  - United States
TA  - Surg Obes Relat Dis
JT  - Surgery for obesity and related diseases : official journal of the American 
      Society for Bariatric Surgery
JID - 101233161
RN  - 0 (Cholesterol, HDL)
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Triglycerides)
SB  - IM
CIN - Surg Obes Relat Dis. 2014 Sep-Oct;10(5):840-1. PMID: 24969091
MH  - Adult
MH  - Aged
MH  - Blood Pressure/physiology
MH  - Cholesterol, HDL/metabolism
MH  - Cholesterol, LDL/metabolism
MH  - Diabetes Mellitus, Type 2/ethnology/*surgery
MH  - Female
MH  - Gastric Bypass/*methods
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Laparoscopy/*methods
MH  - Male
MH  - Middle Aged
MH  - Taiwan/ethnology
MH  - Treatment Outcome
MH  - Triglycerides/metabolism
MH  - Waist Circumference
OTO - NOTNLM
OT  - Asian
OT  - LRYGB
OT  - Metabolic surgery
OT  - Nonobese
OT  - Type 2 diabetes mellitus
EDAT- 2014/05/27 06:00
MHDA- 2015/08/04 06:00
CRDT- 2014/05/27 06:00
PHST- 2013/11/21 00:00 [received]
PHST- 2014/01/03 00:00 [revised]
PHST- 2014/01/06 00:00 [accepted]
PHST- 2014/05/27 06:00 [entrez]
PHST- 2014/05/27 06:00 [pubmed]
PHST- 2015/08/04 06:00 [medline]
AID - S1550-7289(14)00027-6 [pii]
AID - 10.1016/j.soard.2014.01.018 [doi]
PST - ppublish
SO  - Surg Obes Relat Dis. 2014 Sep-Oct;10(5):834-40. doi: 10.1016/j.soard.2014.01.018. 
      Epub 2014 Jan 28.