Improvement of diabetes and hypertension after gastrectomy: A nationwide cohort study
AIM: To evaluate the effect of gastrectomy on diabetes mellitus(DM) and hypertension(HTN) in non-obese gastric cancer patients. METHODS: A total of 100000 patients, diagnosed with either type 2 DM or HTN, were randomly selected from the 2004 Korean National Health Insurance System claims. Among them...
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| Veröffentlicht in: | World journal of gastroenterology : WJG 2015-01, Vol.21 (4), p.1173-1181 |
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| creator | Lee, Eun Kyung Kim, So Young Lee, You Jin Kwak, Mi Hyang Kim, Hak Jin Choi, Il Ju Cho, Soo-Jeong Kim, Young Woo Lee, Jong Yeul Kim, Chan Gyoo Yoon, Hong Man Eom, Bang Wool Kong, Sun-Young Yoo, Min Kyong Park, Jong Hyock Ryu, Keun Won |
| description | AIM: To evaluate the effect of gastrectomy on diabetes mellitus(DM) and hypertension(HTN) in non-obese gastric cancer patients. METHODS: A total of 100000 patients, diagnosed with either type 2 DM or HTN, were randomly selected from the 2004 Korean National Health Insurance System claims. Among them, 360 diabetes and 351 hypertensive patients with gastric cancer who had been regularly treated without chemotherapy from January 2005 to December 2010 were selected. They were divided into three groups according to their treatment methods: total gastrectomy(TG), subtotal gastrectomy(STG) and endoscopic resection(ER). RESULTS: The drug discontinuation rate of antidiabetic and anti-hypertensive agents after gastric cancer treatment was 9.7% and 11.1% respectively. DM appeared to be improved more frequently(22.8%) and earlier(mean ± SE 28.6 ± 1.8 mo) in TG group than in the two other groups [improved in 9.5% of ER group(37.4 ± 1.1 mo) and 6.4% of STG group(47.0 ± 0.8 mo)]. The proportion of patients treated with multiple drugs decreased more notably in TG group compared to others(P = 0.001 in DM, and P = 0.035 in HTN). In TG group, adjusted hazard ratio for theimprovement of DM was 2.87(95%CI: 1.15-7.17) in a multi-variate analysis and better control of DM was observed with survival analysis(P < 0.001).CONCLUSION: TG was found to decrease the need for anti-diabetic medications which can be reflective of improved glycemic control, to a greater extent than either ER or STG in non-obese diabetic patients. |
| doi_str_mv | 10.3748/wjg.v21.i4.1173 |
| format | Article |
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METHODS: A total of 100000 patients, diagnosed with either type 2 DM or HTN, were randomly selected from the 2004 Korean National Health Insurance System claims. Among them, 360 diabetes and 351 hypertensive patients with gastric cancer who had been regularly treated without chemotherapy from January 2005 to December 2010 were selected. They were divided into three groups according to their treatment methods: total gastrectomy(TG), subtotal gastrectomy(STG) and endoscopic resection(ER). RESULTS: The drug discontinuation rate of antidiabetic and anti-hypertensive agents after gastric cancer treatment was 9.7% and 11.1% respectively. DM appeared to be improved more frequently(22.8%) and earlier(mean ± SE 28.6 ± 1.8 mo) in TG group than in the two other groups [improved in 9.5% of ER group(37.4 ± 1.1 mo) and 6.4% of STG group(47.0 ± 0.8 mo)]. The proportion of patients treated with multiple drugs decreased more notably in TG group compared to others(P = 0.001 in DM, and P = 0.035 in HTN). In TG group, adjusted hazard ratio for theimprovement of DM was 2.87(95%CI: 1.15-7.17) in a multi-variate analysis and better control of DM was observed with survival analysis(P &lt; 0.001).CONCLUSION: TG was found to decrease the need for anti-diabetic medications which can be reflective of improved glycemic control, to a greater extent than either ER or STG in non-obese diabetic patients.</description><identifier>ISSN: 1007-9327</identifier><identifier>EISSN: 2219-2840</identifier><identifier>DOI: 10.3748/wjg.v21.i4.1173</identifier><identifier>PMID: 25632190</identifier><language>eng</language><publisher>United States: Baishideng Publishing Group Inc</publisher><subject>Aged ; Antihypertensive Agents - therapeutic use ; Biomarkers - blood ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Blood Pressure - drug effects ; cancer;N ; Chi-Square Distribution ; Diabetes Mellitus - blood ; Diabetes Mellitus - diagnosis ; Diabetes Mellitus - drug therapy ; Diabetes Mellitus - mortality ; Diabetes;Hypertension;Gastrectomy;Gastric ; Drug Therapy, Combination ; Female ; Gastrectomy - adverse effects ; Gastrectomy - methods ; Gastrectomy - mortality ; Gastroscopy ; Humans ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - mortality ; Hypertension - physiopathology ; Hypoglycemic Agents - therapeutic use ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Recovery of Function ; Republic of Korea - epidemiology ; Retrospective Cohort Study ; Retrospective Studies ; Stomach Neoplasms - diagnosis ; Stomach Neoplasms - mortality ; Stomach Neoplasms - surgery ; Time Factors ; Treatment Outcome</subject><ispartof>World journal of gastroenterology : WJG, 2015-01, Vol.21 (4), p.1173-1181</ispartof><rights>The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved. 2015</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-51c5c3bec07b4d8b5747032ed5b012900fc737f2c254baa5790a54682b5167603</citedby><cites>FETCH-LOGICAL-c437t-51c5c3bec07b4d8b5747032ed5b012900fc737f2c254baa5790a54682b5167603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/84123X/84123X.jpg</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306161/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306161/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25632190$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Eun Kyung</creatorcontrib><creatorcontrib>Kim, So Young</creatorcontrib><creatorcontrib>Lee, You Jin</creatorcontrib><creatorcontrib>Kwak, Mi Hyang</creatorcontrib><creatorcontrib>Kim, Hak Jin</creatorcontrib><creatorcontrib>Choi, Il Ju</creatorcontrib><creatorcontrib>Cho, Soo-Jeong</creatorcontrib><creatorcontrib>Kim, Young Woo</creatorcontrib><creatorcontrib>Lee, Jong Yeul</creatorcontrib><creatorcontrib>Kim, Chan Gyoo</creatorcontrib><creatorcontrib>Yoon, Hong Man</creatorcontrib><creatorcontrib>Eom, Bang Wool</creatorcontrib><creatorcontrib>Kong, Sun-Young</creatorcontrib><creatorcontrib>Yoo, Min Kyong</creatorcontrib><creatorcontrib>Park, Jong Hyock</creatorcontrib><creatorcontrib>Ryu, Keun Won</creatorcontrib><title>Improvement of diabetes and hypertension after gastrectomy: A nationwide cohort study</title><title>World journal of gastroenterology : WJG</title><addtitle>World Journal of Gastroenterology</addtitle><description>AIM: To evaluate the effect of gastrectomy on diabetes mellitus(DM) and hypertension(HTN) in non-obese gastric cancer patients. METHODS: A total of 100000 patients, diagnosed with either type 2 DM or HTN, were randomly selected from the 2004 Korean National Health Insurance System claims. Among them, 360 diabetes and 351 hypertensive patients with gastric cancer who had been regularly treated without chemotherapy from January 2005 to December 2010 were selected. They were divided into three groups according to their treatment methods: total gastrectomy(TG), subtotal gastrectomy(STG) and endoscopic resection(ER). RESULTS: The drug discontinuation rate of antidiabetic and anti-hypertensive agents after gastric cancer treatment was 9.7% and 11.1% respectively. DM appeared to be improved more frequently(22.8%) and earlier(mean ± SE 28.6 ± 1.8 mo) in TG group than in the two other groups [improved in 9.5% of ER group(37.4 ± 1.1 mo) and 6.4% of STG group(47.0 ± 0.8 mo)]. The proportion of patients treated with multiple drugs decreased more notably in TG group compared to others(P = 0.001 in DM, and P = 0.035 in HTN). In TG group, adjusted hazard ratio for theimprovement of DM was 2.87(95%CI: 1.15-7.17) in a multi-variate analysis and better control of DM was observed with survival analysis(P &lt; 0.001).CONCLUSION: TG was found to decrease the need for anti-diabetic medications which can be reflective of improved glycemic control, to a greater extent than either ER or STG in non-obese diabetic patients.</description><subject>Aged</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Pressure - drug effects</subject><subject>cancer;N</subject><subject>Chi-Square Distribution</subject><subject>Diabetes Mellitus - blood</subject><subject>Diabetes Mellitus - diagnosis</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes Mellitus - mortality</subject><subject>Diabetes;Hypertension;Gastrectomy;Gastric</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Gastrectomy - adverse effects</subject><subject>Gastrectomy - methods</subject><subject>Gastrectomy - mortality</subject><subject>Gastroscopy</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - mortality</subject><subject>Hypertension - physiopathology</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Proportional Hazards Models</subject><subject>Recovery of Function</subject><subject>Republic of Korea - epidemiology</subject><subject>Retrospective Cohort Study</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - diagnosis</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1007-9327</issn><issn>2219-2840</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkUFv3CAQhVHVqtmkPfdWcezFm4EBY_dQKYraNFKkXpozwhh7idZmA-xG---Lle2qnQsjvY83A4-QTwzWqERz_fI0rg-crb1YM6bwDVlxztqKNwLekhUDUFWLXF2Qy5SeADii5O_JBZc1Fg5W5PF-2sVwcJObMw0D7b3pXHaJmrmnm-POxezm5MNMzZBdpKNJOTqbw3T8Sm_obHLRXnzvqA2bEDNNed8fP5B3g9km9_F0XpHHH99_3_6sHn7d3d_ePFRWoMqVZFZa7JwF1Ym-6aQSCpC7XnbAeAswWIVq4JZL0RkjVQtGirrhnWS1qgGvyLdX392-m1xvyyOi2epd9JOJRx2M1_8rs9_oMRy0QKhZzYrBl5NBDM97l7KefLJuuzWzC_ukWS25QGS4oNevqI0hpeiG8xgGeglDlzB0CUN7oZcwyo3P_2535v_-fgHwZLkJ8_js5_HMtNAs1UoQjWgliqYssnQC_wCeRZca</recordid><startdate>20150128</startdate><enddate>20150128</enddate><creator>Lee, Eun Kyung</creator><creator>Kim, So Young</creator><creator>Lee, You Jin</creator><creator>Kwak, Mi Hyang</creator><creator>Kim, Hak Jin</creator><creator>Choi, Il Ju</creator><creator>Cho, Soo-Jeong</creator><creator>Kim, Young Woo</creator><creator>Lee, Jong Yeul</creator><creator>Kim, Chan Gyoo</creator><creator>Yoon, Hong Man</creator><creator>Eom, Bang Wool</creator><creator>Kong, Sun-Young</creator><creator>Yoo, Min Kyong</creator><creator>Park, Jong Hyock</creator><creator>Ryu, Keun Won</creator><general>Baishideng Publishing Group Inc</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>W91</scope><scope>~WA</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150128</creationdate><title>Improvement of diabetes and hypertension after gastrectomy: A nationwide cohort study</title><author>Lee, Eun Kyung ; Kim, So Young ; Lee, You Jin ; Kwak, Mi Hyang ; Kim, Hak Jin ; Choi, Il Ju ; Cho, Soo-Jeong ; Kim, Young Woo ; Lee, Jong Yeul ; Kim, Chan Gyoo ; Yoon, Hong Man ; Eom, Bang Wool ; Kong, Sun-Young ; Yoo, Min Kyong ; Park, Jong Hyock ; Ryu, Keun Won</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-51c5c3bec07b4d8b5747032ed5b012900fc737f2c254baa5790a54682b5167603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Pressure - drug effects</topic><topic>cancer;N</topic><topic>Chi-Square Distribution</topic><topic>Diabetes Mellitus - blood</topic><topic>Diabetes Mellitus - diagnosis</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetes Mellitus - mortality</topic><topic>Diabetes;Hypertension;Gastrectomy;Gastric</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Gastrectomy - adverse effects</topic><topic>Gastrectomy - methods</topic><topic>Gastrectomy - mortality</topic><topic>Gastroscopy</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - mortality</topic><topic>Hypertension - physiopathology</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Proportional Hazards Models</topic><topic>Recovery of Function</topic><topic>Republic of Korea - epidemiology</topic><topic>Retrospective Cohort Study</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - diagnosis</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Lee, Eun Kyung</creatorcontrib><creatorcontrib>Kim, So Young</creatorcontrib><creatorcontrib>Lee, You Jin</creatorcontrib><creatorcontrib>Kwak, Mi Hyang</creatorcontrib><creatorcontrib>Kim, Hak Jin</creatorcontrib><creatorcontrib>Choi, Il Ju</creatorcontrib><creatorcontrib>Cho, Soo-Jeong</creatorcontrib><creatorcontrib>Kim, Young Woo</creatorcontrib><creatorcontrib>Lee, Jong Yeul</creatorcontrib><creatorcontrib>Kim, Chan Gyoo</creatorcontrib><creatorcontrib>Yoon, Hong Man</creatorcontrib><creatorcontrib>Eom, Bang Wool</creatorcontrib><creatorcontrib>Kong, Sun-Young</creatorcontrib><creatorcontrib>Yoo, Min Kyong</creatorcontrib><creatorcontrib>Park, Jong Hyock</creatorcontrib><creatorcontrib>Ryu, Keun Won</creatorcontrib><collection>中文科技期刊数据库</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>中文科技期刊数据库-7.0平台</collection><collection>中文科技期刊数据库-医药卫生</collection><collection>中文科技期刊数据库- 镜像站点</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of gastroenterology : WJG</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Eun Kyung</au><au>Kim, So Young</au><au>Lee, You Jin</au><au>Kwak, Mi Hyang</au><au>Kim, Hak Jin</au><au>Choi, Il Ju</au><au>Cho, Soo-Jeong</au><au>Kim, Young Woo</au><au>Lee, Jong Yeul</au><au>Kim, Chan Gyoo</au><au>Yoon, Hong Man</au><au>Eom, Bang Wool</au><au>Kong, Sun-Young</au><au>Yoo, Min Kyong</au><au>Park, Jong Hyock</au><au>Ryu, Keun Won</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improvement of diabetes and hypertension after gastrectomy: A nationwide cohort study</atitle><jtitle>World journal of gastroenterology : WJG</jtitle><addtitle>World Journal of Gastroenterology</addtitle><date>2015-01-28</date><risdate>2015</risdate><volume>21</volume><issue>4</issue><spage>1173</spage><epage>1181</epage><pages>1173-1181</pages><issn>1007-9327</issn><eissn>2219-2840</eissn><abstract>AIM: To evaluate the effect of gastrectomy on diabetes mellitus(DM) and hypertension(HTN) in non-obese gastric cancer patients. METHODS: A total of 100000 patients, diagnosed with either type 2 DM or HTN, were randomly selected from the 2004 Korean National Health Insurance System claims. Among them, 360 diabetes and 351 hypertensive patients with gastric cancer who had been regularly treated without chemotherapy from January 2005 to December 2010 were selected. They were divided into three groups according to their treatment methods: total gastrectomy(TG), subtotal gastrectomy(STG) and endoscopic resection(ER). RESULTS: The drug discontinuation rate of antidiabetic and anti-hypertensive agents after gastric cancer treatment was 9.7% and 11.1% respectively. DM appeared to be improved more frequently(22.8%) and earlier(mean ± SE 28.6 ± 1.8 mo) in TG group than in the two other groups [improved in 9.5% of ER group(37.4 ± 1.1 mo) and 6.4% of STG group(47.0 ± 0.8 mo)]. The proportion of patients treated with multiple drugs decreased more notably in TG group compared to others(P = 0.001 in DM, and P = 0.035 in HTN). In TG group, adjusted hazard ratio for theimprovement of DM was 2.87(95%CI: 1.15-7.17) in a multi-variate analysis and better control of DM was observed with survival analysis(P &lt; 0.001).CONCLUSION: TG was found to decrease the need for anti-diabetic medications which can be reflective of improved glycemic control, to a greater extent than either ER or STG in non-obese diabetic patients.</abstract><cop>United States</cop><pub>Baishideng Publishing Group Inc</pub><pmid>25632190</pmid><doi>10.3748/wjg.v21.i4.1173</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Antihypertensive Agents - therapeutic use Biomarkers - blood Blood Glucose - drug effects Blood Glucose - metabolism Blood Pressure - drug effects cancer N Chi-Square Distribution Diabetes Mellitus - blood Diabetes Mellitus - diagnosis Diabetes Mellitus - drug therapy Diabetes Mellitus - mortality Diabetes Hypertension Gastrectomy Gastric Drug Therapy, Combination Female Gastrectomy - adverse effects Gastrectomy - methods Gastrectomy - mortality Gastroscopy Humans Hypertension - diagnosis Hypertension - drug therapy Hypertension - mortality Hypertension - physiopathology Hypoglycemic Agents - therapeutic use Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Proportional Hazards Models Recovery of Function Republic of Korea - epidemiology Retrospective Cohort Study Retrospective Studies Stomach Neoplasms - diagnosis Stomach Neoplasms - mortality Stomach Neoplasms - surgery Time Factors Treatment Outcome |
| title | Improvement of diabetes and hypertension after gastrectomy: A nationwide cohort study |
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