Comparison of Benefits and Risks of Metabolic Surgery for Long‐Term (5 Years) Weight Loss and Diabetes Remission in Overweight/Obese Patients With Type 2 Diabetes: A Systematic Review and Network Meta‐Analysis of Randomized Trials

作者：Xiaoyu Zang, Lin Tong, Jing Ma, Ying Zhang, Boxun Zhang, Yi Huang, Danni Zhou, Lu Ding, Lili Zhang, Linhua Zhao · 发表于：Diabetes/Metabolism Research and Reviews · 年份：2025 · DOI：10.1002/dmrr.70033 · 被引用次数：10 · 研究领域：Bariatric Surgery and Outcomes、Body Contouring and Surgery、Cardiovascular Function and Risk Factors

BACKGROUND: While there have been studies comparing the efficiency of several metabolic operations in overweight or obese individuals with type 2 diabetes mellitus (T2DM), there is currently no comprehensive evidence about the complete remission of diabetes and its long-term safety. METHODS: This comprehensive review and network meta-analysis encompassed searches of many databases including PubMed, Web of Science, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, ClinicalTrials.gov, and Google Scholar. The search was conducted from the beginning of these databases' existence until 1 May 2024. The study selected randomized controlled trials (RCTs) with a 5-year follow-up period to compare the clinical benefits and evaluate the occurrence of side events. The network meta-analysis employed a random-effects model. The registration number for PROSPERO is CRD42023412536. RESULTS: There was a total of 16 RCTs that included 1059 patients. A total of 897 patients, representing 84.7% of the entire sample, successfully completed the 5-year follow-up. Seven metabolic procedures were conducted. All ensuing estimates are to the comparison with a non-surgical treatment (NST). The evidence strongly supports that One-anastomosis gastric bypass (OAGB) is the most effective surgical procedure for achieving long-term complete remission of diabetes (relative risk [RR] 10.28, 95% CI 1.87 to 56.40). Additionally, Biliopancreatic diversion (BPD) is the most effective proc...