Roux-en-Y Gastric Bypass Could Slow Progression of Retinopathy in Type 2 Diabetes: A Pilot Study

被引:21
作者
Banks, Jenny
Adams, Simon T.
Laughlan, Kirstie
Allgar, Victoria
Miller, Glenn V.
Jayagopal, Vijay
Gale, Richard
Sedman, Peter
Leveson, Stephen H.
机构
[1] Department of Surgery, Torbay Hospital, Newton Road, Torquay, TQ2 7AA, Devon
[2] Department of Surgery, The York Hospital, Wigginton Road, York, YO31 8HE, North Yorkshire
[3] Hull York Medical School, University of York, John Hughlings Jackson Building, University of York, Heslington, York, YO10 5DD, North Yorkshire
[4] Department of Diabetes and Endocrinology, The York Hospital, Wigginton Road, York, YO31 8HE, North Yorkshire
[5] Department of Ophthalmology, The York Hospital, Wigginton Road, York, YO31 8HE, North Yorkshire
[6] Department of Surgery, Castle Hill Hospital, Castle Road, Cottingham, HU16 5JQ, East Yorkshire
关键词
Bariatric surgery; Roux-en Y gastric bypass; Type 2 diabetes mellitus; Diabetic retinopathy; Obesity; RETINAL VASCULAR CALIBER; WEIGHT; RISK; REMISSION; SURGERY; THERAPY;
D O I
10.1007/s11695-014-1476-7
中图分类号
R61 [外科手术学];
学科分类号
100210 [外科学];
摘要
Type 2 diabetes mellitus (T2DM) is a well-recognised complication of obesity. One of the microvascular complications of T2DM is diabetic retinopathy (DR). Bariatric surgery has been shown to effectively treat obesity and can induce remission of T2DM. It is not known what effect this improvement may have on pre-existing DR. We aimed to investigate this. A dual-centre, observer-blinded, case-control study investigated the progression of DR in patients who received Roux-en-Y gastric bypass (treatment group (TG)), compared with controls who received medical therapy (control group (CG)) for their T2DM. Retinal images were taken pre-operatively and approximately 2 years post-operatively for the TG and over a 2-year interval for the CG. Data were collected for confounding variables, including glycaemic control (HbA(1c)) and BMI. Forty-five patients were recruited (TG = 21, CG = 24). Groups were significantly heterogeneous. DR showed significant progression for those in the CG (p = 0.03) but not in TG (p = 0.135), no significant difference was found when adjusting for confounding variables (p = 0.480). There was a significant trend in favour of surgery in improvement of glycaemic control (p = 0.017). The trends within these pilot data may represent a real difference in the progression of DR in patients who have received surgery, compared with medical treatment alone. Due to heterogeneity of group characteristics, further work needs to be done to validate these results. Should there be a true difference, there will be potential cost savings for the National Health Service (NHS) along with a reduced burden of disease for patients.
引用
收藏
页码:777 / 781
页数:5
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