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Preoperative Fasting Plasma C-Peptide Levels as Predictors of Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: A Systematic Review and Meta-Analysis

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机构: [1]Capital Med Univ, Beijing Tian Tan Hosp, Dept Gen Surg, 6 Tiantan Xili, Beijing 100050, DC, Peoples R China
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关键词: diabetes bariatric surgery C-peptide remission meta-analysis

摘要:
Aims: The study evaluated the predictive role of preoperative fasting C-peptide, hemoglobin (Hb)A1c, fasting plasma glucose (FPG), and body mass index (BMI) levels on diabetes remission in patients with type 2 diabetes following bariatric surgery. Methods: Medline, PubMed, Central, and Google Scholar databases of up to September 7, 2016 were searched using the following terms: type 2 diabetes mellitus, gastric bypass, Roux-en-Y, anastomosis, C-peptide, weight loss, HbA/HbA1c, predictive/predictor. Results: Meta-analysis of the pooled data indicated that fasting C-peptide was predictive of increased chance of remission of type 2 diabetes (pooled difference in means = 0.93, 95% confidence interval [CI] = 0.61 to 1.25, p < .001). The analysis also found that FPG (pooled standardized mean difference = -0.42, 95% CI: -0.64 to -0.20, p < .004) and HbA1c levels (pooled difference in means = -1.05, 95% CI: -1.48 to -0.62, p < .001) were associated with reduced odds of type 2 diabetes remission. BMI was not found to be associated with remission (pooled difference in means = 0.29, 95% CI: 0.30 to 0.88, p = .343). In general, subgroup analysis, which evaluated the pooled data from the retrospective and prospective studies separately, gave similar results. Conclusions: Preoperative fasting plasma C-peptide was associated with increased type 2 diabetes remission after bariatric surgery, whereas baseline HbA1c and FPG levels were associated with reduced chance of remission. These parameters may be used as a guideline in weighing the risks and benefits for surgical intervention in patients with type 2 diabetes.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 外科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 外科
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出版当年[2015]版:
Q3 SURGERY
最新[2023]版:
Q2 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Capital Med Univ, Beijing Tian Tan Hosp, Dept Gen Surg, 6 Tiantan Xili, Beijing 100050, DC, Peoples R China
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tian Tan Hosp, Dept Gen Surg, 6 Tiantan Xili, Beijing 100050, DC, Peoples R China
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