Study design and Patient Selection
A retrospective observational study of a collected database was conducted in patients undergoing LSG in the Department of metabolic and obesity surgery of the First Affiliated Hospital of Jinan University (Guangzhou, China) between January 2016 and October 2018. Inclusion criteria were body mass index (BMI) ≥ 32.5 kg/m2 or ≥ 27.5 kg/m2 with one or more co-morbid conditions (hypertension, type 2 diabetes, dyslipidemia, or OSA) who failing managed by lifestyle modification. Exclusion criteria were patients with a history of bariatric surgery or cholecystectomy. Moreover, patient with Pre-diabetes was diagnosed according to CAD guideline [17]. whom states either impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), with 6.0-6.4% HbA1c falling into the prediabetes diagnosis criteria. Patients are divided into 3 groups, T2DM, pre-diabetes and non-diabetes according to their diabetes status. All participants had been informed and consented to involved in this study.
All patients completed a systematic route examination investigation before bariatric surgery and each follow-up visit at 1, 3, 6, 12 months post op. It includes routine physical examination, weight, obesity-related comorbidities investigation, and route laboratory tests. Data, including age, gender, body weight, body height, BMI, surgery methods, HbA1c, insulin, C-peptide, fasting glucose, total bile acid (TBA), cholesterol (CHOL), triglyceride (TG), LDL-c, HDL-c, alanine transaminase (ALT), aspartate transaminase (AST), are collected from medical records from baselines and its following visits.
Postoperative Management Follow-up
All patients, underwent surgery, are suggested follow-up revisit for physical examination at 1, 3, 6, 12 months. They were advised to take calcium tablet (Caltrate®), which includes 600 mg calcium and 125 IU vitamin D3; and multivitamin supplementations (Centrum®), which includes 162 mg calcium and 400 IU vitamin D, 0.4 mg folate, 6μg vitamin B12, 18 mg iron, 36.3 mg chlorine, 125 mg phosphorus, 40 mg potassium, 100 mg magnesium, 5000 IU vitamin A, 15 mg zinc, 20 mg nicotinamide, 2.5 mg manganese, 1.5 mg vitamin B1, 25 μg chromium, 1.7 mg vitamin B2, 25μg molybdenum, 2 mg vitamin B6, 25μg selenium, 60 mg vitamin C, 5μg nickel, 10μg tin,25μg vitamin K1, 10μg silicon, 30μg biotin, 2 mg copper, and 10μg vanadium. Lifelong prescription of both supplements was recommended.
Surgery Technique
All surgical procedures were performed laparoscopically under standardized methodology [18] by an experienced surgical experts. Stomach is resected from the starting point for stapling, approximately 2-4 cm above the pylorus, followed by entire fundus resection.
Statistical Analysis
The data were reported as mean, standard deviation, and percentage. Statistical Product and Service Solution version 19.0 (SPSS 19.0, SPSS Inc., Chicago, IL) was used for data analysis. Student’s t-test or Mann–Whitney test analyzed the continuous data. P≤0.05 was considered statistically significant. The Pearson or the Spearman coefficients were used for correlation analyses. Excel illustrated line chart for listing variations of examined items. .