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Tytuł:
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Metabolic Effects of Gastrectomy and Duodenal Bypass in Early Gastric Cancer Patients with T2DM: A Prospective Single-Center Cohort Study.
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Autorzy:
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Lee YK; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea.
Lee EK; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea.; Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.
Lee YJ; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea.
Eom BW; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
Yoon HM; Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
Kim YI; Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
Cho SJ; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
Lee JY; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
Kim CG; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
Kong SY; Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.; Department of Laboratory Medicine, National Cancer Center, Goyang 10408, Korea.
Yoo MK; Department of Clinical Nutrition, National Cancer Center, Goyang 10408, Korea.
Hwangbo Y; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea.; Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.
Kim YW; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
Choi IJ; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.; Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.
Kim HJ; Division of Cardiology, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea.
Kwak MH; Division of Cardiology, Department of Internal Medicine, National Cancer Center, Goyang 10408, Korea.
Ryu KW; Center for Gastric Cancer, National Cancer Center, Goyang 10408, Korea.
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Źródło:
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Journal of clinical medicine [J Clin Med] 2021 Sep 04; Vol. 10 (17). Date of Electronic Publication: 2021 Sep 04.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Basel, Switzerland : MDPI AG, [2012]-
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References:
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Grant Information:
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1210552-3 Republic of Korea National Cancer Center; 1510740-1 Republic of Korea National Cancer Center; 1410650-1 Republic of Korea National Cancer Center
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Contributed Indexing:
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Keywords: early gastric cancer; endoscopic submucosal dissection; gastrectomy; glycemic control; insulin resistance; type 2 diabetes mellitus
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Entry Date(s):
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Date Created: 20210910 Latest Revision: 20210913
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Update Code:
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20240105
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PubMed Central ID:
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PMC8432535
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DOI:
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10.3390/jcm10174008
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PMID:
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34501456
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We evaluated the metabolic effects of gastrectomies and endoscopic submucosal dissections (ESDs) in early gastric cancer (EGC) patients with type 2 diabetes mellitus (T2DM). Forty-one EGC patients with T2DM undergoing gastrectomy or ESD were prospectively evaluated. Metabolic parameters in the patients who underwent gastrectomy with and without a duodenal bypass (groups 1 and 2, n = 24 and n = 5, respectively) were compared with those in patients who underwent ESD (control, n = 12). After 1 year, the proportions of improved/equivocal/worsened glycemic control were 62.5%/29.2%/8.3% in group 1, 40.0%/60.0%/0.0% in group 2, and 16.7%/50.0%/33.3% in the controls, respectively ( p = 0.046). The multivariable ordered logistic regression analysis results showed that both groups had better 1-year glycemic control. Groups 1 and 2 showed a significant reduction in postprandial glucose (-97.9 and -67.8 mg/dL), body mass index (-2.1 and -2.3 kg/m 2 ), and glycosylated hemoglobin (group 1 only, -0.5% point) (all p < 0.05). Furthermore, improvements in group 1 were more prominent when preoperative leptin levels were high ( p for interaction < 0.05). Metabolic improvements in both groups were also observed for insulin resistance, leptin, plasminogen activator inhibitor-1, and resistin. Gastrectomy improved glycemic control and various metabolic parameters in EGC patients with T2DM. Patients with high leptin levels may experience greater metabolic benefits from gastrectomy with duodenal bypass.