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The effect of metabolic surgery on nonobese patients (BMI<30 kg/m2) with type 2 diabetes: a systematic review

  • Author Footnotes
    1 Z.P.H., Y.G., and C.Q.L. contributed equally to this work.
    Zhi-Ping Huang
    Footnotes
    1 Z.P.H., Y.G., and C.Q.L. contributed equally to this work.
    Affiliations
    Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, People’s Republic of China
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  • Author Footnotes
    1 Z.P.H., Y.G., and C.Q.L. contributed equally to this work.
    Yan Guo
    Footnotes
    1 Z.P.H., Y.G., and C.Q.L. contributed equally to this work.
    Affiliations
    Department of Endocrinology, Changhai Hospital, The Second Military Medical University, Shanghai, People’s Republic of China
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  • Author Footnotes
    1 Z.P.H., Y.G., and C.Q.L. contributed equally to this work.
    Chao-Qian Liu
    Footnotes
    1 Z.P.H., Y.G., and C.Q.L. contributed equally to this work.
    Affiliations
    Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People’s Republic of China
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  • Lin Qi
    Affiliations
    Department of Orthopaedics, the Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
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  • Da-Jin Zou
    Correspondence
    Correspondence: Da-Jin Zou, M.D., Department of Endocrinology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China.
    Affiliations
    Department of Endocrinology, Changhai Hospital, The Second Military Medical University, Shanghai, People’s Republic of China
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  • Wei-Ping Zhou
    Correspondence
    Correspondence: Wei-Ping Zhou, M.D., Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai, 200438, China.
    Affiliations
    Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, People’s Republic of China
    Search for articles by this author
  • Author Footnotes
    1 Z.P.H., Y.G., and C.Q.L. contributed equally to this work.
Published:February 15, 2018DOI:https://doi.org/10.1016/j.soard.2018.02.013

      Abstract

      Background

      The influence of metabolic surgery on the glucose and lipid profiles of nonobese body mass index<30 kg/m2 patients with type 2 diabetes, particularly the effect ≥1 year, remains unknown.

      Methods

      PubMed and Ovid Embase were used.

      Setting

      University hospitals.

      Results

      In total, 21 studies including 921 patients were examined in this systematic review, the results of which revealed decrease in body mass index, waist circumference, fasting plasma glucose, glycosylated hemoglobin A1C, fasting C-peptide, fasting insulin, homeostasis model of assessment for insulin resistance index, triglycerides, total cholesterol, and low-density lipoprotein cholesterol. An increase in high-density lipoprotein cholesterol was also observed. The diabetes remission rates ranged from 13.3% to 90.2% according to 20 studies. The incidence of gastrointestinal bleeding ranged from 1% to 10% according to 9 studies. Four studies reported anemia after Roux-en-Y gastric bypass or one-anastomosis gastric bypass, with the incidence ranging from 8% to 33%.

      Conclusions

      Nonobese patients can achieve improvements in weight-related indices and glucose and lipid profiles in the short and medium term after metabolic surgery; however, the complications of metabolic surgery warrant further attention.

      Keywords

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