title: A comparative study of the metabolic effects of LSG and LRYGB in Chinese diabetes patients with BMI<35 kg/m2.
abstract: BACKGROUND
  The metabolic effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes (T2D) patients who do not meet National Institutes of Health indications has not been well studied.
  
  
  OBJECTIVE
  To compare the effectiveness of LSG and LRYGB in Chinese T2D patients with body mass index (BMI)<35 kg/m2.
  
  
  METHODS
  University hospital, China.
  
  
  METHODS
  A nonrandomized cohort of patients who underwent LRYGB (n = 64) and LSG (n = 19) were followed up for 3 years and the outcomes (weight loss and remission of diabetes and other metabolic parameters) were compared. Univariate and multivariate analyses were applied to find associated parameters of T2D remission.
  
  
  RESULTS
  In total, 5 patients (6%) were lost to follow-up. No significant differences in mean percentage of excess weight loss and BMI were observed between the 2 groups at 2 years. At 3-year follow-up, the LRYGB group had significantly higher percentage of excess weight loss and lower BMI. The total (complete and partial) remission rate achieved with both bariatric procedures was 75.9% at 1 year and 56.4% at 3 years. Surgical safety, diabetes remission, and remission of other obesity-related co-morbidities were comparable between the 2 groups. Patients who achieved complete or partial remission had lower fasting plasma glucose, lower plasma glucose at 2 hours, lower glycated hemoglobin, and higher fasting C peptide than the other patients at baseline. High recurrence rates of hypertension and hyperuricemia were observed at 3 years postoperation.
  
  
  CONCLUSIONS
  Both LSG and LRYGB are safe and effective bariatric procedures for T2D in this Chinese population with diabetes and BMI<35 kg/m2.
authors.affiliation: Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China.
authors.forename: Hong-Xu
authors.initials: HX
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, P.R. China.
authors.forename: Si-Qin
authors.initials: SQ
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, P.R. China.
authors.forename: Hao-Ming
authors.initials: HM
authors.lastname: Tian
authors.affiliation: Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China.
authors.forename: Zong-Guang
authors.initials: ZG
authors.lastname: Zhou
authors.affiliation: Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China. Electronic address: zhongcheng1963@126.com.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002096:C-Peptide / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000378:metabolism / Q000601:surgery*; D004812:Epidemiologic Methods; D005215:Fasting / Q000097:blood; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000601:surgery; D033461:Hyperuricemia / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009765:Obesity / Q000208:ethnology / Q000601:surgery; D012008:Recurrence; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin
keywords: BMI<35 kg/m(2); Bariatric surgery; Roux-en-Y gastric bypass; Sleeve gastrectomy; Type 2 diabetes mellitus