Effect of LSG on insulin resistance and atherogenic index of plasma in patients with type 2 diabetes mellitus complicated with obesity / 中华内分泌外科杂志

ABSTRACT

Objective:By comparing the changes of metabolic parameters before and after laparoscopic sleeve gastectomy (LSG) in patients with type 2 diabetes mellitus (T2DM) and obesity, the insulin resistance index (HOMA-IR) and atherogenic index of plasma (AIP) were calculated to evaluate the effect of metabolic surgery on insulin resistance and atherosclerosis in patients with type 2 diabetes mellitus (T2DM) and obesity.Methods:LSG treatment were retrospectively analyzed in 54 patients with type 2 diabetes mellitus and obesity, detection of preoperative and postoperative 1 month, 6 month of fasting plasma glucose (FPG), fasting insulin (FINS), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), measuring blood pressure, body weight, calculating body mass index, and according to the steady state evaluation model and the formula for calculating HOMA-IR and AIP. Before and after surgery, paired t test was used, and Pearson correlation analysis and multiple stepwise regression analysis.Results:FPG, FINS, TG, HOMA-IR and AIP were (6.38±2.03) mmol/L and (5.36±1.33) mmol/L, (20.42±25.77) uU/mLand (11.22±3.62) uU/mL, (1.94±2.81) mmol/Land (1.70±2.33) mmol/L, (5.60±7.52) and (2.58±0.80), (0.15±0.27) and (0.08±0.25) ,which were significantly lower than those before surgery ( P<0.05) ,HDL-C was (1.04±0.20) mmol/L and (1.10±0.18) mmol/L at 1 and 6 months after operation, respectively, which was higher than that before operation ( P<0.05) .Preoperative correlation analysis showed that AIP was positively correlated with FPG, TG and HOMA-IR ( P<0.05), and negatively correlated with HDL-C ( P<0.05) .The results of multiple stepwise regression analysis showed that FPG, TG and HDL-C were independent influencing factors of AIP ( P<0.05) . Conclusion:LSG surgery can effectively reduce the blood glucose and lipid levels in patients with type 2 diabetes complicated with obesity, improve insulin resistance and reduce the plasma atherosclerosis index.