Journal of Shanghai Jiao Tong University (Medical Science) ›› 2023, Vol. 43 ›› Issue (10): 1332-1338.doi: 10.3969/j.issn.1674-8115.2023.10.016
• Review • Previous Articles
Received:
2023-03-26
Accepted:
2023-09-15
Online:
2023-10-28
Published:
2023-10-28
Contact:
YU Haoyong
E-mail:yingyi0508@126.com;yuhaoyong111@163.com
CLC Number:
SHAN Yingyi, YU Haoyong. Advances in preoperative medical management of metabolic surgery[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(10): 1332-1338.
Add to citation manager EndNote|Ris|BibTeX
URL: https://xuebao.shsmu.edu.cn/EN/10.3969/j.issn.1674-8115.2023.10.016
Treatment | Preoperative treatment | Note |
---|---|---|
Metformin | To discontinue on the day of surgery | Gastrointestinal discomfort and lactic acidosis should be avoided; Patients with stage 4 severe chronic kidney disease (CKD) [estimated glomerular filtration rate 30 mL·min-1·(1.73 m2)-1] are contraindicated |
Sulfonylureas and meglitinides | To discontinue at the start of preoperative diet (i.e., 2‒4 weeks before surgery) | Hypoglycemia and weight gain should be avoided |
Thiazolidinediones | To discontinue on the day of surgery | Weight gain, fluid retention, and edema should all be avoided |
ɑ-glucosidase inhibitors | To discontinue on the day before metabolic surgery | Gastrointestinal side effects should be avoided |
Dipeptidyl peptidase-4 (DPP-4) inhibitors | To discontinue on the day of surgery | Patients with heart failure, arthralgia, skin conditions, allergic reactions and acute pancreatitis should use it with caution |
Sodium-glucose cotransporter-2 (SGLT2) inhibitors | To discontinue 3 d prior to surgery (2 weeks prior to surgery for those on a low-calorie ketogenic diet) | Genitourinary tract infections, hypotension, fractures, acute kidney injury, ketoacidosis, and rare cases of Fournier's gangrene should all be taken seriously |
Glucagon-like peptide 1 (GLP-1) receptor agonists | To discontinue on the day of surgery | Gastrointestinal side effects should be avoided; Patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 are contraindicated |
Tab 1 Recommendations for preoperative treatment with oral hypoglycemic agents and non-insulin injectables
Treatment | Preoperative treatment | Note |
---|---|---|
Metformin | To discontinue on the day of surgery | Gastrointestinal discomfort and lactic acidosis should be avoided; Patients with stage 4 severe chronic kidney disease (CKD) [estimated glomerular filtration rate 30 mL·min-1·(1.73 m2)-1] are contraindicated |
Sulfonylureas and meglitinides | To discontinue at the start of preoperative diet (i.e., 2‒4 weeks before surgery) | Hypoglycemia and weight gain should be avoided |
Thiazolidinediones | To discontinue on the day of surgery | Weight gain, fluid retention, and edema should all be avoided |
ɑ-glucosidase inhibitors | To discontinue on the day before metabolic surgery | Gastrointestinal side effects should be avoided |
Dipeptidyl peptidase-4 (DPP-4) inhibitors | To discontinue on the day of surgery | Patients with heart failure, arthralgia, skin conditions, allergic reactions and acute pancreatitis should use it with caution |
Sodium-glucose cotransporter-2 (SGLT2) inhibitors | To discontinue 3 d prior to surgery (2 weeks prior to surgery for those on a low-calorie ketogenic diet) | Genitourinary tract infections, hypotension, fractures, acute kidney injury, ketoacidosis, and rare cases of Fournier's gangrene should all be taken seriously |
Glucagon-like peptide 1 (GLP-1) receptor agonists | To discontinue on the day of surgery | Gastrointestinal side effects should be avoided; Patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 are contraindicated |
Micronutrient | Prevention | Treatment |
---|---|---|
Iron | 45‒60 mg/d by oral administration | 150‒200 mg/d by oral administration |
Zinc | 15 mg/d by oral administration | 60 mg twice a day by oral administration |
Copper | 2 mg/d by oral administration (≥1 mg Cu per 8‒15 mg Zn to prevent copper deficiency is recommended) | Severe deficiency: 2‒4 mg/d by intravenous injection for 6 d |
Vitamin A | 6 000 IU/d by oral administration | Without corneal changes: 10 000‒25 000 IU/d by oral administration. With corneal changes: 50 000‒100 000 IU by intramuscular injection for 3 d, followed by 50 000 IU/d by intramuscular injection for 2 weeks to achieve clinical improvement |
Vitamin B1 | 12 mg/d by oral administration | 500 mg/d by intravenous injection for 3‒5 d, followed by 250 mg/d by intravenous injection for 3‒5 d or until symptoms disappear. If further treatment is required, 100 mg/d is taken by oral administration |
Vitamin B6 | 400 μg/d by oral administration | 1 000 μg/d by oral administration |
Vitamin B12 | 250‒350 μg/d or 1 000 μg/wk by sublingual administration | 1 000‒2 000 μg/d by sublingual administration |
Vitamin D2 or D3 | Vitamin D2 or D3 3 000 IU/d by oral administration to reach normal concentrations of 30 ng/mL | Vitamin D2 or D3 50 000 IU/week for 8 weeks, followed by maintenance therapy of 1 500‒2 000 IU/d by oral administration to achieve normal concentrations |
Vitamin E | 400 IU/d by oral administration | 800‒1 200 IU/d by oral administration |
Vitamin K | 300 μg/d by oral administration | 10 mg by intramuscular injection, followed by 1‒2 mg/week by oral administration |
Tab 2 Prevention and treatment of micronutrient deficiencies
Micronutrient | Prevention | Treatment |
---|---|---|
Iron | 45‒60 mg/d by oral administration | 150‒200 mg/d by oral administration |
Zinc | 15 mg/d by oral administration | 60 mg twice a day by oral administration |
Copper | 2 mg/d by oral administration (≥1 mg Cu per 8‒15 mg Zn to prevent copper deficiency is recommended) | Severe deficiency: 2‒4 mg/d by intravenous injection for 6 d |
Vitamin A | 6 000 IU/d by oral administration | Without corneal changes: 10 000‒25 000 IU/d by oral administration. With corneal changes: 50 000‒100 000 IU by intramuscular injection for 3 d, followed by 50 000 IU/d by intramuscular injection for 2 weeks to achieve clinical improvement |
Vitamin B1 | 12 mg/d by oral administration | 500 mg/d by intravenous injection for 3‒5 d, followed by 250 mg/d by intravenous injection for 3‒5 d or until symptoms disappear. If further treatment is required, 100 mg/d is taken by oral administration |
Vitamin B6 | 400 μg/d by oral administration | 1 000 μg/d by oral administration |
Vitamin B12 | 250‒350 μg/d or 1 000 μg/wk by sublingual administration | 1 000‒2 000 μg/d by sublingual administration |
Vitamin D2 or D3 | Vitamin D2 or D3 3 000 IU/d by oral administration to reach normal concentrations of 30 ng/mL | Vitamin D2 or D3 50 000 IU/week for 8 weeks, followed by maintenance therapy of 1 500‒2 000 IU/d by oral administration to achieve normal concentrations |
Vitamin E | 400 IU/d by oral administration | 800‒1 200 IU/d by oral administration |
Vitamin K | 300 μg/d by oral administration | 10 mg by intramuscular injection, followed by 1‒2 mg/week by oral administration |
1 | World Health Organization. Obesity and overweight[EB/OL]. (2021-06-09) [2023-03-28]. https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight. |
2 | WANG L, ZHOU B, ZHAO Z, et al. Body-mass index and obesity in urban and rural China: findings from consecutive nationally representative surveys during 2004-18[J]. Lancet, 2021, 398(10294): 53-63. |
3 | ADAMS T D, DAVIDSON L E, LITWIN S E, et al. Weight and metabolic outcomes 12 years after gastric bypass[J]. N Engl J Med, 2017, 377(12): 1143-1155. |
4 | SCHAUER P R, BHATT D L, KIRWAN J P, et al. Bariatric surgery versus intensive medical therapy for diabetes: 5-year outcomes[J]. N Engl J Med, 2017, 376(7): 641-651. |
5 | MINGRONE G, PANUNZI S, DE GAETANO A, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial[J]. Lancet, 2021, 397(10271): 293-304. |
6 | SYN N L, CUMMINGS D E, WANG L Z, et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants[J]. Lancet, 2021, 397(10287): 1830-1841. |
7 | ANGRISANI L, SANTONICOLA A, IOVINO P, et al. Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters[J]. Obes Surg, 2021, 31(5): 1937-1948. |
8 | DU X, DAI R, ZHOU H X, et al. Bariatric surgery in China: how is this new concept going?[J]. Obes Surg, 2016, 26(12): 2906-2912. |
9 | EISENBERG D, SHIKORA S A, AARTS E, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery[J]. Surg Obes Relat Dis, 2022, 18(12): 1345-1356. |
10 | 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华内分泌代谢杂志, 2021, 37(4): 311-398. |
Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) [J]. Chinese Journal of Endocrinology and Metabolism, 2021, 37(4): 311-398. | |
11 | VAN WISSEN J, BAKKER N, DOODEMAN H J, et al. Preoperative methods to reduce liver volume in bariatric surgery: a systematic review[J]. Obes Surg, 2016, 26(2): 251-256. |
12 | KOUTOUKIDIS D A, KOSHIARIS C, HENRY J A, et al. The effect of the magnitude of weight loss on non-alcoholic fatty liver disease: a systematic review and meta-analysis[J]. Metabolism, 2021, 115: 154455. |
13 | ROMAN M, MONAGHAN A, SERRAINO G F, et al. Meta-analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes[J]. Br J Surg, 2019, 106(3): 181-189. |
14 | SAMAAN J S, ZHAO J, QIAN E, et al. Preoperative weight loss as a predictor of bariatric surgery postoperative weight loss and complications[J]. J Gastrointest Surg, 2022, 26(1): 86-93. |
15 | ANDERIN C, GUSTAFSSON U O, HEIJBEL N, et al. Weight loss before bariatric surgery and postoperative complications: data from the Scandinavian Obesity Registry (SOReg)[J]. Ann Surg, 2015, 261(5): 909-913. |
16 | SARNO G, CALABRESE P, FRIAS-TORAL E, et al. The relationship between preoperative weight loss and intra and post-bariatric surgery complications: an appraisal of the current preoperative nutritional strategies[J]. Crit Rev Food Sci Nutr, 2022: 1-9. |
17 | HUTCHEON D A, HALE A L, EWING J A, et al. Short-term preoperative weight loss and postoperative outcomes in bariatric surgery[J]. J Am Coll Surg, 2018, 226(4): 514-524. |
18 | TABESH M R, MALEKLOU F, EJTEHADI F, et al. Nutrition, physical activity, and prescription of supplements in pre- and post-bariatric surgery patients: a practical guideline[J]. Obes Surg, 2019, 29(10): 3385-3400. |
19 | WOLF R M, OSHIMA K, CANNER J K, et al. Impact of a preoperative low-calorie diet on liver histology in patients with fatty liver disease undergoing bariatric surgery[J]. Surg Obes Relat Dis, 2019, 15(10): 1766-1772. |
20 | LEAN M E J. Low-calorie diets in the management of type 2 diabetes mellitus[J]. Nat Rev Endocrinol, 2019, 15(5): 251-252. |
21 | STEVEN S, HOLLINGSWORTH K G, AL-MRABEH A, et al. Very low-calorie diet and 6 months of weight stability in type 2 diabetes: pathophysiological changes in responders and nonresponders[J]. Diabetes Care, 2016, 39(5): 808-815. |
22 | PARRETTI H M, JEBB S A, JOHNS D J, et al. Clinical effectiveness of very-low-energy diets in the management of weight loss: a systematic review and meta-analysis of randomized controlled trials[J]. Obes Rev, 2016, 17(3): 225-234. |
23 | GASTALDO I, CASAS R, MOIZÉ V. Clinical impact of Mediterranean diet adherence before and after bariatric surgery: a narrative review[J]. Nutrients, 2022, 14(2): 393. |
24 | TETTAMANZI F, BAGNARDI V, LOUCA P, et al. A high protein diet is more effective in improving insulin resistance and glycemic variability compared to a Mediterranean diet: a cross-over controlled inpatient dietary study[J]. Nutrients, 2021, 13(12): 4380. |
25 | VICENTE MARTIN C, RABAGO TORRE L R, CASTILLO HERRERA L A, et al. Preoperative intragastric balloon in morbid obesity is unable to decrease early postoperative morbidity of bariatric surgery (sleeve gastrectomy and gastric bypass): a clinical assay[J]. Surg Endosc, 2020, 34(6): 2519-2531. |
26 | SARI C, SEIP R L, UMASHANKER D. Case report: off label utilization of topiramate and metformin in patients with BMI ≥50 kg/m2 prior to bariatric surgery[J]. Front Endocrinol (Lausanne), 2021, 12: 588016. |
27 | GADDE K M, MARTIN C K, BERTHOUD H R, et al. Obesity: pathophysiology and management[J]. J Am Coll Cardiol, 2018, 71(1): 69-84. |
28 | AMINIAN A, BRETHAUER S A, ANDALIB A, et al. Individualized metabolic surgery score: procedure selection based on diabetes severity[J]. Ann Surg, 2017, 266(4): 650-657. |
29 | JONES C E, GRAHAM L A, MORRIS M S, et al. Association between preoperative hemoglobin A1c levels, postoperative hyperglycemia, and readmissions following gastrointestinal surgery[J]. JAMA Surg, 2017, 152(11): 1031-1038. |
30 | HART A, GOFFREDO P, CARROLL R, et al. Optimizing bariatric surgery outcomes: the impact of preoperative elevated hemoglobin A1c levels on composite perioperative outcome measures[J]. Surg Endosc, 2021, 35(8): 4618-4623. |
31 | American Diabetes Association Professional Practice Committee. 16. diabetes care in the hospital: standards of medical care in diabetes-2022[J]. Diabetes Care, 2022, 45(Suppl 1): S244-S253. |
32 | SIMHA V, SHAH P. Perioperative glucose control in patients with diabetes undergoing elective surgery[J]. JAMA, 2019, 321(4): 399-400. |
33 | MOREY-VARGAS O L, AMINIAN A, STECKNER K, et al. Perioperative management of diabetes in patients undergoing bariatric and metabolic surgery: a narrative review and the Cleveland Clinic practical recommendations[J]. Surg Obes Relat Dis, 2022, 18(8): 1087-1101. |
34 | MULLA C M, BALOCH H M, HAFIDA S. Management of diabetes in patients undergoing bariatric surgery[J]. Curr Diab Rep, 2019, 19(11): 112. |
35 | COURCOULAS A P, KING W C, BELLE S H, et al. Seven-year weight trajectories and health outcomes in the longitudinal assessment of bariatric surgery (LABS) study[J]. JAMA Surg, 2018, 153(5): 427-434. |
36 | HAYOZ C, HERMANN T, RAPTIS D A, et al. Comparison of metabolic outcomes in patients undergoing laparoscopic roux-en-Y gastric bypass versus sleeve gastrectomy: a systematic review and meta-analysis of randomised controlled trials[J]. Swiss Med Wkly, 2018, 148: w14633. |
37 | 中国血脂管理指南修订联合专家委员会. 中国血脂管理指南(2023年)[J]. 中华心血管病杂志, 2023, 51(3): 221-255. |
Joint Committee on the Chinese Guidelines for Lipid Management. Chinese guidelines for lipid management (2023)[J]. Chinese Journal of Cardiology, 2023, 51(3): 221-255. | |
38 | GUAN B S, YANG J G, CHEN Y Y, et al. Nutritional deficiencies in Chinese patients undergoing gastric bypass and sleeve gastrectomy: prevalence and predictors[J]. Obes Surg, 2018, 28(9): 2727-2736. |
39 | AL-MUTAWA A, ANDERSON A K, ALSABAH S, et al. Nutritional status of bariatric surgery candidates[J]. Nutrients, 2018, 10(1): 67. |
40 | BEN-PORAT T, ELAZARY R, YUVAL J B, et al. Nutritional deficiencies after sleeve gastrectomy: can they be predicted preoperatively?[J]. Surg Obes Relat Dis, 2015, 11(5): 1029-1036. |
41 | ENANI G, BILGIC E, LEBEDEVA E, et al. The incidence of iron deficiency anemia post-Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review[J]. Surg Endosc, 2020, 34(7): 3002-3010. |
42 | PARROTT J M, CRAGGS-DINO L, FARIA S L, et al. The optimal nutritional programme for bariatric and metabolic surgery[J]. Curr Obes Rep, 2020, 9(3): 326-338. |
43 | SHERF DAGAN S, GOLDENSHLUGER A, GLOBUS I, et al. Nutritional recommendations for adult bariatric surgery patients: clinical practice[J]. Adv Nutr, 2017, 8(2): 382-394. |
44 | PARROTT J, FRANK L, RABENA R, et al. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the surgical weight loss patient 2016 update: micronutrients[J]. Surg Obes Relat Dis, 2017, 13(5): 727-741. |
45 | MOHAN S, SAMAAN J S, SAMAKAR K. Impact of smoking on weight loss outcomes after bariatric surgery: a literature review[J]. Surg Endosc, 2021, 35(11): 5936-5952. |
46 | INADOMI M, IYENGAR R, FISCHER I, et al. Effect of patient-reported smoking status on short-term bariatric surgery outcomes[J]. Surg Endosc, 2018, 32(2): 720-726. |
47 | WOOD G C, BENOTTI P N, LEE C J, et al. Evaluation of the association between preoperative clinical factors and long-term weight loss after Roux-en-Y gastric bypass[J]. JAMA Surg, 2016, 151(11): 1056-1062. |
48 | MALIK S, MITCHELL J E, ENGEL S, et al. Psychopathology in bariatric surgery candidates: a review of studies using structured diagnostic interviews[J]. Compr Psychiatry, 2014, 55(2): 248-259. |
49 | MÜLLER M, NETT P C, BORBÉLY Y M, et al. Mental illness has a negative impact on weight loss in bariatric patients: a 4-year follow-up[J]. J Gastrointest Surg, 2019, 23(2): 232-238. |
50 | CHAO A M, WADDEN T A, FAULCONBRIDGE L F, et al. Binge-eating disorder and the outcome of bariatric surgery in a prospective, observational study: two-year results[J]. Obesity (Silver Spring), 2016, 24(11): 2327-2333. |
51 | PEKKARINEN T, MUSTONEN H, SANE T M, et al. Long-term effect of gastric bypass and sleeve gastrectomy on severe obesity: do preoperative weight loss and binge eating behavior predict the outcome of bariatric surgery?[J]. Obes Surg, 2016, 26(9): 2161-2167. |
52 | FUCHS H F, LAUGHTER V, HARNSBERGER C R, et al. Patients with psychiatric comorbidity can safely undergo bariatric surgery with equivalent success[J]. Surg Endosc, 2016, 30(1): 251-258. |
53 | MECHANICK J I, APOVIAN C, BRETHAUER S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures—2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, the Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists[J]. Obesity (Silver Spring), 2020, 28(4): O1-O58. |
54 | CARTER J, CHANG J, BIRRIEL T J, et al. ASMBS position statement on preoperative patient optimization before metabolic and bariatric surgery[J]. Surg Obes Relat Dis, 2021, 17(12): 1956-1976. |
55 | MAREK R J, HEINBERG L J, LAVERY M, et al. A review of psychological assessment instruments for use in bariatric surgery evaluations[J]. Psychol Assess, 2016, 28(9): 1142-1157. |
[1] | WU Kaimin, MA Jing, ZHAO Xuyun. Combined effects of intermittent fasting and thermogenic fat activation on the treatment and prevention of obesity in mice [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(9): 1131-1144. |
[2] | XUE Yanbin, QI Jiying, ZHANG Zizheng, JING Renjie, SUN Wen, YAO Huayan, HE Ping, CUI Bin, NING Guang. Construction of Shanghai Diabetes Clinical Database and real-world study [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(9): 1145-1152. |
[3] | LU Xiaobing, YUE Jiang, HE Shengyun, DONG Ying, LU Qing, MA Jing. Effect of intramuscular adipose tissue in the skeletal muscle of thigh on glucose metabolism in male patients with obesity [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(9): 1169-1174. |
[4] | WU Lingheng, CHEN Jianxiong, ZHANG Mengjiao, SHA Lei, CAO Mengmeng, SHEN Cuiqin, DU Lianfang, LI Zhaojun. A study of the effect of suboptimal glycemic control on subclinical myocardial systolic function in patients with T2DM [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(8): 1024-1031. |
[5] | GAO Nan, HAO Gem, MA Bingjie, JIN Tian, MA Ke, LIU Xiaoming. Translocator protein activates autophagy in diabetic neuropathic pain rats via regulation of the Keap1/Nrf2/HO-1 signaling [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(8): 988-996. |
[6] | WANG Jinghui, ZHANG Hong, ZHANG Rong, PENG Danfeng, YU Hairong, CHEN Xianghui, XUAN Ye, HU Cheng, GU Yunjuan. Screening for pathogenic variants in obese cohort using whole-exome sequencing [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(7): 882-889. |
[7] | MENG Xiangyu, YAN Dandan, CHEN Xianghui, LAI Siyu, XU Yun, GENG Ruina, ZHANG Hong, ZHANG Rong, HU Cheng, YAN Jing. Identification of pathogenic mutations for a Wolfram syndrome pedigree by whole exome sequencing and analysis of its clinical characteristics [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(7): 898-905. |
[8] | LIU Qianruo, FANG Zichen, WU Yuhan, ZHONG Xianxin, GUO Muhe, JIA Jie. Research progress in the relationship between gut microbia and its metabolites and gestational diabetes mellitus [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(5): 641-647. |
[9] | ZHANG Yue, QU Lei, GU Qin, ZHU Yiqing, MA Liying, SUN Wenguang. Effect of continuous positive urine ketone body on clinical outcomes of pregnant women with gestational diabetes mellitus and newborn [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(3): 314-319. |
[10] | ZHANG Juan, GE Xiaoxu, ZHANG Rong, JIANG Fusong, JIANG Yanyan, LI Ming, LI Tiantian, LIU Chanwei, CHEN Yating, LIU Limei. Screening and functional analysis of mutations in NEUROD1 gene in pedigrees of maturity-onset diabetes of the young [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(10): 1255-1261. |
[11] | WU Ruifang, FENG Ming, MENG Jian. Review of role of fatty acid binding protein-4 in obesity-associated tumors [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(10): 1311-1316. |
[12] | XIE Xiaolei, JIANG Peixin, ZHANG Jinghong, MO Junjian, WU Kefan, ZENG Kangyi. A review of RIZ1 regulation of the signal pathways in obesity and tumors [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(1): 114-119. |
[13] | JIA Weiping. New progress and prospects of blood glucose monitoring technology [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(9): 1171-1175. |
[14] | LI Wen, LI Yuan, YE Haiyun, ZHANG Xiaoxiao, QIAO Tong, LI Pin. Observation on early microvascular changes in macular area of the fundus in children with type 1 diabetes mellitus [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(9): 1311-1314. |
[15] | WANG Jie, WU Hui, LU Lingpeng, YANG Kefeng, ZHU Jie, ZHOU Hengyi, YAO Die, GAO Ya, FENG Yuting, LIU Yuhong, JIA Jie. Dynamic changes in gut microbiota of women with gestational diabetes mellitus and the correlation with blood glucose, blood lipid and diet [J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(9): 1336-1346. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||