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Background <p>Endoscopic sleeve gastroplasty (ESG) is an incisionless weight loss procedure that has been demonstrated to be safe and effective for the treatment of obesity; however, the efficacy of ESG for the treatment of comorbid type 2 diabetes mellitus (T2DM) and other components of metabolic syndrome (MetS) has been less well studied. We aimed to conduct a systematic review and meta-analysis of available literature to evaluate the outcomes of ESG on T2DM and MetS.</p> Methods <p>Bibliographic databases were systematically searched for studies assessing the outcomes of ESG on T2DM and MetS. Studies were included if they reported at least one objective outcome related to T2DM or other components of MetS, including hyperlipidemia (HLD), hypertriglyceridemia, and hypertension (HTN). This study was deemed IRB exempt.</p> Results <p>Ten studies with 4320 patients were included. At 12 months, ESG was associated with significant improvements in T2DM, HLD, and HTN, with risk difference of − 0.72 [95% CI, − 0.87 to − 0.58, <i>p</i> &lt; 0.00001], − 0.65 [95% CI, − 0.78 to − 0.52, <i>p</i> &lt; 0.00001], and − 0.60 [95% CI, − 0.66 to − 0.53, <i>p</i> &lt; 0.00001], respectively. Disease improvement was defined as patients being able to stop some or all of their related treatment medications. Additionally, there were significant reductions in hemoglobin A1c (HGBA1c), fasting blood glucose, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein, and triglycerides.</p> Conclusions <p>ESG is an effective modality for the treatment of comorbid T2DM and MetS in patients with obesity. Additional studies are needed to establish long-term responses and to compare ESG against established pharmacologic and surgical techniques.</p> Graphical Abstract <p></p>

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Endoscopic Sleeve Gastroplasty for the Treatment of Metabolic Syndrome: A Systematic Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2025年4月8日

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  • Mark Hanscom,
  • Muhammad Usman Baig,
  • Drew Wright,
  • Laith Baqain,
  • Kate Elise Johnson,
  • Vivek Kumbhari,
  • Shelby Sullivan,
  • Barham Abu Dayyeh,
  • SriHari Mahadev,
  • Carolyn Newberry,
  • Kartik Sampath,
  • David Carr-Locke,
  • Christopher Thompson,
  • Reem Sharaiha

摘要

Background

Endoscopic sleeve gastroplasty (ESG) is an incisionless weight loss procedure that has been demonstrated to be safe and effective for the treatment of obesity; however, the efficacy of ESG for the treatment of comorbid type 2 diabetes mellitus (T2DM) and other components of metabolic syndrome (MetS) has been less well studied. We aimed to conduct a systematic review and meta-analysis of available literature to evaluate the outcomes of ESG on T2DM and MetS.

Methods

Bibliographic databases were systematically searched for studies assessing the outcomes of ESG on T2DM and MetS. Studies were included if they reported at least one objective outcome related to T2DM or other components of MetS, including hyperlipidemia (HLD), hypertriglyceridemia, and hypertension (HTN). This study was deemed IRB exempt.

Results

Ten studies with 4320 patients were included. At 12 months, ESG was associated with significant improvements in T2DM, HLD, and HTN, with risk difference of − 0.72 [95% CI, − 0.87 to − 0.58, p < 0.00001], − 0.65 [95% CI, − 0.78 to − 0.52, p < 0.00001], and − 0.60 [95% CI, − 0.66 to − 0.53, p < 0.00001], respectively. Disease improvement was defined as patients being able to stop some or all of their related treatment medications. Additionally, there were significant reductions in hemoglobin A1c (HGBA1c), fasting blood glucose, homeostatic model assessment for insulin resistance (HOMA-IR), low-density lipoprotein, and triglycerides.

Conclusions

ESG is an effective modality for the treatment of comorbid T2DM and MetS in patients with obesity. Additional studies are needed to establish long-term responses and to compare ESG against established pharmacologic and surgical techniques.

Graphical Abstract