PMID- 34501456 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210913 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 10 IP - 17 DP - 2021 Sep 4 TI - Metabolic Effects of Gastrectomy and Duodenal Bypass in Early Gastric Cancer Patients with T2DM: A Prospective Single-Center Cohort Study. LID - 10.3390/jcm10174008 [doi] LID - 4008 AB - We evaluated the metabolic effects of gastrectomies and endoscopic submucosal dissections (ESDs) in early gastric cancer (EGC) patients with type 2 diabetes mellitus (T2DM). Forty-one EGC patients with T2DM undergoing gastrectomy or ESD were prospectively evaluated. Metabolic parameters in the patients who underwent gastrectomy with and without a duodenal bypass (groups 1 and 2, n = 24 and n = 5, respectively) were compared with those in patients who underwent ESD (control, n = 12). After 1 year, the proportions of improved/equivocal/worsened glycemic control were 62.5%/29.2%/8.3% in group 1, 40.0%/60.0%/0.0% in group 2, and 16.7%/50.0%/33.3% in the controls, respectively (p = 0.046). The multivariable ordered logistic regression analysis results showed that both groups had better 1-year glycemic control. Groups 1 and 2 showed a significant reduction in postprandial glucose (-97.9 and -67.8 mg/dL), body mass index (-2.1 and -2.3 kg/m(2)), and glycosylated hemoglobin (group 1 only, -0.5% point) (all p < 0.05). Furthermore, improvements in group 1 were more prominent when preoperative leptin levels were high (p for interaction < 0.05). Metabolic improvements in both groups were also observed for insulin resistance, leptin, plasminogen activator inhibitor-1, and resistin. Gastrectomy improved glycemic control and various metabolic parameters in EGC patients with T2DM. Patients with high leptin levels may experience greater metabolic benefits from gastrectomy with duodenal bypass. FAU - Lee, Young Ki AU - Lee YK AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea. FAU - Lee, Eun Kyung AU - Lee EK AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea. AD - Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea. FAU - Lee, You Jin AU - Lee YJ AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea. FAU - Eom, Bang Wool AU - Eom BW AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. FAU - Yoon, Hong Man AU - Yoon HM AD - Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea. AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. FAU - Kim, Young-Il AU - Kim YI AUID- ORCID: 0000-0002-2614-3419 AD - Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea. AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. FAU - Cho, Soo Jeong AU - Cho SJ AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. FAU - Lee, Jong Yeul AU - Lee JY AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. FAU - Kim, Chan Gyoo AU - Kim CG AUID- ORCID: 0000-0002-1651-2559 AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. FAU - Kong, Sun-Young AU - Kong SY AUID- ORCID: 0000-0003-0620-4058 AD - Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea. AD - Department of Laboratory Medicine, National Cancer Center, Goyang 10408, Korea. FAU - Yoo, Min Kyong AU - Yoo MK AD - Department of Clinical Nutrition, National Cancer Center, Goyang 10408, Korea. FAU - Hwangbo, Yul AU - Hwangbo Y AUID- ORCID: 0000-0001-7129-2133 AD - Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea. AD - Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea. FAU - Kim, Young-Woo AU - Kim YW AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. FAU - Choi, Il Ju AU - Choi IJ AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. AD - Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea. FAU - Kim, Hak Jin AU - Kim HJ AD - Division of Cardiology, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea. FAU - Kwak, Mi Hyang AU - Kwak MH AD - Division of Cardiology, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea. FAU - Ryu, Keun Won AU - Ryu KW AD - Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea. LA - eng GR - 1210552-3/National Cancer Center/Republic of Korea GR - 1510740-1/National Cancer Center/Republic of Korea GR - 1410650-1/National Cancer Center/Republic of Korea PT - Journal Article DEP - 20210904 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC8432535 OTO - NOTNLM OT - early gastric cancer OT - endoscopic submucosal dissection OT - gastrectomy OT - glycemic control OT - insulin resistance OT - type 2 diabetes mellitus COIS- The authors declare that there are no conflict of interest. The funding sources were not involved in study design, data collection, analysis, interpretation of data, or the decision to submit the paper for publication. EDAT- 2021/09/11 06:00 MHDA- 2021/09/11 06:01 PMCR- 2021/09/04 CRDT- 2021/09/10 01:03 PHST- 2021/07/14 00:00 [received] PHST- 2021/08/20 00:00 [revised] PHST- 2021/08/30 00:00 [accepted] PHST- 2021/09/10 01:03 [entrez] PHST- 2021/09/11 06:00 [pubmed] PHST- 2021/09/11 06:01 [medline] PHST- 2021/09/04 00:00 [pmc-release] AID - jcm10174008 [pii] AID - jcm-10-04008 [pii] AID - 10.3390/jcm10174008 [doi] PST - epublish SO - J Clin Med. 2021 Sep 4;10(17):4008. doi: 10.3390/jcm10174008.