title: Effect of laparoscopic Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus with hypertension: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effect of laparoscopic Roux-en-Y gastric bypass (RYGB) surgery compared with usual care with and without Exenatide therapy in obese people with type 2 diabetes mellitus (T2DM) and hypertension.
  
  
  METHODS
  108 obese T2DM with hypertension were enrolled and randomly allocated to usual care (group A), usual care plus Exenatide (group B), and RYGB surgery (group C). Demographic characteristics, metabolic parameters and cardiac structure/function along with inflammatory cytokines were measured and compared before and after 12 months.
  
  
  RESULTS
  At 12 months, diabetes remission had occurred in no patients in groups A and B versus 90% in group C, and there was a significant decrease in requirement of antihypertensive drugs in group C compared with groups A and B (P<0.05). Other parameters (body mass index, hemoglobin A1c, homeostasis model assessment of insulin resistance, lipids), inflammation index (high sensitivity C-reactive protein, tumor necrosis factor-α, high molecular weight adiponectin) and cardiac structure (left ventricular mass index) were significantly improved in groups B and C, but patients in group C had the greatest degree of improvement (P<0.05).
  
  
  CONCLUSIONS
  RYGB surgery improves a number of parameters including cardiovascular function in obese hypertensive people with T2DM. This is likely to be due to, at least in part, an improvement in the abnormal metabolic panel and to reduced inflammation.
authors.affiliation: Department of Endocrinology, Southwest Hospital of Third Military Medical University, Chongqing 400038, China; Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA. Electronic address: ziwen.liang9@gmail.com.
authors.forename: Ziwen
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Endocrinology, Southwest Hospital of Third Military Medical University, Chongqing 400038, China.
authors.forename: Qinan
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Endocrinology, Southwest Hospital of Third Military Medical University, Chongqing 400038, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Southwest Hospital of Third Military Medical University, Chongqing 400038, China.
authors.forename: Peiwu
authors.initials: P
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Southwest Hospital of Third Military Medical University, Chongqing 400038, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Xinshou
authors.initials: X
authors.lastname: Ouyang
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011379:Prognosis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D015431:Weight Loss
chemical_list: D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D014409:Tumor Necrosis Factor-alpha