title: Long-term effects of laparoscopic sleeve gastrectomy versus roux-en-Y gastric bypass for the treatment of Chinese type 2 diabetes mellitus patients with body mass index 28-35 kg/m(2).
abstract: BACKGROUND
  To compare long term effects of two bariatric procedures for Chinese type 2 diabetes mellitus (T2DM) patients with a body mass index (BMI) of 28-35 kg/m(2).
  
  
  METHODS
  Sixty four T2DM patients with Glycated hemoglobin A1c (HbA1c) ≧ 7.0 % were randomly assigned to receive laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) procedure. Weight, percentage of excess weight loss (%EWL), BMI, waist circumference, HbA1c, fasting blood glucose (FBG), and C-peptide were measured. Serum lipid levels were also measured during three-year postoperative follow-up visits.
  
  
  RESULTS
  Fifty five patients completed the 36-month follow-up. Both groups had similar baseline anthropometric and biochemical measures. At the end point, 22 patients (78.6 %) in SG group and 23 patients (85.2 %) in RYGB group achieved complete remission of diabetes mellitus with HbA1c < 6.0 % (P = 0.525) and without taking diabetic medications, and 25 patients in each group (89.3 % vs. 92.6 %) gained successful treatment of diabetes with HbA1c≦6.5 % (P = 0.100). Change in HbA1c, FBG and C peptide were comparable in the two groups. The RYGB group had significantly greater weight loss than the SG group [percentage of total weight loss (%TWL) of 31.0 % vs. 27.1 % (P = 0.049), %EWL of 92.3 % vs. 81.9 % (P = 0.003), and change in BMI of 11.0 vs. 9.1 kg/m(2)(P = 0.017), respectively]. Serum lipids in each group were also greatly improved.
  
  
  CONCLUSIONS
  In this three-year study, SG had similar positive effects on diabetes and dyslipidemia compared to RYGB in Chinese T2DM patients with BMI of 28-35 kg/m(2). Longer term follow-ups and larger sample studies are needed to confirm these outcomes, however.
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
authors.forename: Jingge
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China. twcc@jnu.edu.cn.
authors.forename: Cunchuan
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
authors.forename: Guo
authors.initials: G
authors.lastname: Cao
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
authors.forename: Wah
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
authors.forename: Shuqing
authors.initials: S
authors.lastname: Yu
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
authors.forename: Hening
authors.initials: H
authors.lastname: Zhai
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Pan
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications* / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin