Abstract: FR-PO242
The Effects and Prognosis of Bariatric Surgery on Diabetic Nephropathy and Retinopathy in Obese Patients with Type 2 Diabetes Mellitus
Session Information
- Diabetic Kidney Disease: Advancing Treatment
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Li, Shiqi, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Fan, Ying, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Wang, Niansong, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
Background
The prevalence of obesity has increased dramatically during the past 3 decades, resulting in a large number of diabetes mellitus (DM) and its complications, including diabetic nephropathy (DN) and diabetic retinopathy (DR), the two most common microvascular complications. Bariatric surgery has been approved as an effective and potentially useful method to improve hyperglycemia condition in T2DM patients as well as reduce patient’s body weight. However, the association between bariatric surgery and the onset and the progression of DN or DR in obese patients with type 2 diabetes mellitus (T2DM) hasn’t been well studied.
Methods
A total of 127obese obese patients diagnosed with T2DM underwent bariatric surgery in Shanghai Jiao Tong University Affiliate Sixth People’s Hospital from Jan. 2013 to Jan. 2018 and prospectively followed up for one year. The inclusion criteria included: (1) patients aged from 18-65 years old, (2) BMI over 28 kg/m2, (3)a diagnosis of T2DM, (4) a fasting C-peptide by the oral glucose tolerance test >1 ng/mL and a ratio of peak to fasting value >2 ng/ ml. Those with type 1 diabetes, latent autoimmune diabetes in adults, established diagnoses of non-diabetic nephropathy, malignancy, debilitating disease, unresolved psychiatric illness, or substance abuse were excluded from the study. Anthropometric and biochemical parameters were assessed at baseline and 1 year after surgery.
Results
In all patients, body mass index (BMI), blood pressure, fasting blood-glucose, HbA1c, uric acid, blood lipid, urine albumin creatinine ratio (UACR) all decreased significantly 1 year after surgery compared with baseline. 77 out of 127 patients (60.6%) had albuminuria at baseline, and the total remission of albuminuria was 57.9%, no patients had new-onset of albuminuria during the follow-up period. Logistic regression analysis showed that obesity, hypertension, glycemia, dyslipidemia and DR were associated with DN, and DR correlated with DN more strongly than other factors (OR=1.904). Preoperativesystolic pressure and UACR levels, as well as DR could be predictors for DN remission. However, there was no significant difference between baseline and 1 year after intervention in the changes in retinopathy.
Conclusion
Bariatric surgery could be a potential therapy in obese patients with T2DM and might have a protective role in diabetic kidney injury.