Evidence map›Paper›PMID 36750042›Full record

ArticleObesity facts2023

Factors Associated with Relapse of Type 2 Diabetes Mellitus after Laparoscopic Sleeve Gastrectomy in Japanese Subjects: A Subgroup Analysis of J-SMART Study.

Yasuhiro Watanabe, Takashi Yamaguchi, Daiji Nagayama, Sho Tanaka, Akira Sasaki, Takeshi Naitoh, Hisahiro Matsubara, Koutaro Yokote, Shinichi Okazumi, Satoshi Ugi and 11 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Obesity facts, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Yasuhiro WatanabeCenter of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Chiba, Japan, y.watanabe1216@gmail.com.
Takashi YamaguchiCenter of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
Daiji NagayamaCenter of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
Sho TanakaCenter of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
Akira SasakiDepartment of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
Takeshi NaitohDepartment of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
Hisahiro MatsubaraDepartment of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Koutaro YokoteDepartment of Endocrinology, Haematology and Gerontology, Chiba University Graduate School of Medicine., Chiba, Japan.
Shinichi OkazumiDepartment of Surgery, Toho University Sakura Medical Center, Chiba, Japan.
Satoshi UgiDepartment of Medicine, Shiga University of Medical Science, Shiga, Japan.
Hiroshi YamamotoDepartment of Surgery, Kohnan Hospital, Shiga, Japan.
Masayuki OhtaDepartment of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.
Yasushi IshigakiDivision of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
Kazunori KasamaWeight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
Yosuke SekiWeight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
Motoyoshi TsujinoDepartment of Endocrinology and Metabolism, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Kohji ShiraiDepartment of Internal Medicine, Mihama Hospital, Chiba, Japan.
Yasuhiro MiyazakiDepartment of Surgery, Osaka General Medical Center, Osaka, Japan.
Takayuki MasakiDepartment of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan.
Atsuhito SaikiCenter of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
Ichiro TatsunoCenter of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLaparoscopic sleeve gastrectomy (LSG) for morbidly obese patients often results in remission of type 2 diabetes (T2DM), but diabetes relapses in some of those patients. The frequency of T2DM relapse in Asians and the factors involved have not been adequately investigated.

methodsThe J-SMART study was conducted on 322 Japanese subjects with body mass index (BMI) ≥32 kg/m2 who underwent LSG at 10 accredited centers in Japan between 2011 and 2014. Of these, 82 T2DM subjects with diabetes in complete or partial remission at 1 year after LSG and followed postoperatively for 5 years were included in the subgroup analysis and classified into two groups: diabetes remission-maintained and diabetes relapse.

resultsThe mean age of all included subjects was 49.2 years, median BMI was 41.5 kg/m2, and median HbA1c was 6.7%. Compared with the diabetes remission-maintained group, the diabetes relapse group at 5 years after LSG had significantly higher preoperative HbA1c, number of antidiabetic medications, and high-density lipoprotein cholesterol level; and lower BMI and homeostasis model assessment-beta cell function (HOMA-β). As many as 83.0% of the subjects were able to achieve HbA1c <7% at 5 years after LSG, but 26.8% of the subjects had diabetes relapse. Preoperative HbA1c significantly contributed to diabetes relapse (odds ratio 1.54, p = 0.049). In addition, the diabetes relapse group tended to have lower percentage total weight loss (%TWL) at 1 year after LSG and higher percentage weight regain (%WR) from postoperative nadir weight, compared with the diabetes remission-maintained group. The hazard ratio for diabetes relapse was 3.14-fold higher in subjects with %TWL ≥20% and %WR ≥25%, and 5.46-fold higher in those with %TWL <20% and %WR ≥25%, compared with %TWL ≥20% and %WR <25%.

conclusionWhile LSG provides a high remission rate for T2DM, relapse is not uncommon. Preoperative HbA1c, poor weight loss, and excess weight regain after LSG contribute to diabetes relapse, suggesting the importance of treatment strategies focusing on these factors.

Indexed as

Diabetes Mellitus, Type 2LaparoscopyObesity, MorbidBody Mass IndexEast Asian PeopleGastrectomyGlycated HemoglobinHumansMiddle AgedOverweightRetrospective StudiesTreatment OutcomeWeight GainWeight LossGlycated HemoglobinDiabetes relapseLaparoscopic sleeve gastrectomyObesityWeight regain

Identifiers

PMID36750042
PMCPMC10028371

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.