【提要】 近年来，代谢手术因其对肥胖型T2DM具有较显著、持久的控糖、减重和缓解其他代谢异常和伴发疾病的疗效而备受关注。以往的临床实践和指南关注的焦点多集中于手术适应证，尤其是BMI切点上。近年来指南的BMI切点呈下降趋势，BMI分界值趋于模糊，这得益于增量的临床证据使临床工作者对代谢手术治疗意义的认识已不再局限于对肥胖症和糖尿病本身的改善，而更注重对患者远期多重代谢及心血管危险因素的综合防治和全面获益的诉求。

　　【关键词】 糖尿病;肥胖症;代谢手术;体重指数切点

　　Comprehensive assessment of BMI cut-off point in metabolic surgery from the view of guideline CHEN Jing，TONG Wei-dong.Center for Hypertension and Metabolic Diseases，Department of Hypertension and Endocrinology，Daping Hospital，Third Military Medical University，Chongqing 400042，China

　　【Abstract】 Recently，metabolic surgery has received much concern for its notable and everlasting effectiveness on glucose control，weight loss and other metabolic disorders and concomitant diseases. Previous clinical practice and guidelines mostly focused on surgical indications，especially BMI cut-off point. In recent years，BMI cut-off point in guidelines has shown a downtrend and BMI cut-off value has tended to become obscure，which harvested from that clinical staff have realized the importance of comprehensive control for long-term multiple metabolism and risk factors and overall benefit of the patients through increased clinical evidences and no longer limited to the improvement of obesity and diabetes itself.

　　【Key words】 Diabetes mellitus; Obesity; Metabolic surgery; BMI cut point