To compare the clinical efficacy of gastric bypass in obese patients with T2DM with different BMI. Serum leptin, adiponectin, triglyceride (TG), cholesterol (CHOL) were measured as the indicators to show clinical efficacy after laparoscopic gastric bypass surgery (LRYGB). For patients with high BMI and patients with low BMI, the therapeutic effect of LRYGB surgical diabetes is more significant. The postoperative remission rate of diabetes in the high BMI group was not correlated with the preoperative lipid metabolism index but was positively correlated with the postoperative lipid metabolism index CHOL, TG, leptin, adiponectin. The postoperative remission rate of diabetes in the low BMI group was positively correlated with the preoperative abnormal lipid metabolism of the patients, and positively correlated with the postoperative remission of leptin and adiponectin, but was not correlated with the postoperative remission of total CHOL and TG. The increase of serum adiponectin level and the decrease of leptin resistance after LRYGB surgery restored the metabolic balance of leptin and adiponectin, improved insulin resistance (IR), and thus improved blood glucose level. Therefore, LRYGB has a definite therapeutic effect on obese patients with T2DM, and elevated adiponectin and improved leptin resistance are some of the mechanisms of surgical treatment of diabetes.

中文翻译：

---

胃旁路对2型糖尿病患者BMI和脂质代谢的影响。

比较不同BMI的肥胖T2DM患者胃旁路手术的临床疗效。血清瘦素，脂联素，甘油三酸酯（TG），胆固醇（CHOL）作为指标显示腹腔镜胃搭桥手术（LRYGB）后的临床疗效。对于BMI高和BMI低的患者，LRYGB手术糖尿病的治疗效果更为显着。高BMI组糖尿病患者的术后缓解率与术前脂质代谢指数无关，但与术后脂质代谢指数CHOL，TG，瘦素，脂联素呈正相关。低BMI组糖尿病患者的术后缓解率与患者术前脂质代谢异常呈正相关，与瘦素和脂联素的术后缓解呈正相关，但与总CHOL和TG的术后缓解无相关性。LRYGB手术后血清脂联素水平的升高和瘦素抵抗力的降低恢复了瘦素和脂联素的代谢平衡，改善了胰岛素抵抗（IR），从而改善了血糖水平。因此，LRYGB对肥胖的T2DM患者具有明确的治疗作用，脂联素升高和瘦素抵抗力增强是糖尿病外科治疗的一些机制。改善胰岛素抵抗（IR），从而改善血糖水平。因此，LRYGB对肥胖的T2DM患者具有明确的治疗作用，脂联素升高和瘦素抵抗力增强是糖尿病外科治疗的一些机制。改善胰岛素抵抗（IR），从而改善血糖水平。因此，LRYGB对肥胖的T2DM患者具有明确的治疗作用，脂联素升高和瘦素抵抗力增强是糖尿病外科治疗的一些机制。