【提要】  代谢手术已被国内外指南列为2型糖尿病治疗选择之一，临床实践中也证实其可有效缓解糖尿病。但目前其作用机制尚不明确，主要有“胃肠激素假说”“脂肪-胰岛轴假说”“炎症介质假说”及“肠道菌群假说”等。另外，该疗法对糖尿病前期、多囊卵巢综合征等疾病也有显著益处。

【关键词】  代谢手术；糖尿病，2型；糖尿病前期；多囊卵巢综合征

Mechanism and clinical application of bariatric-metabolic surgery  XIA Yi-wen, HAN Jun-feng, LIU Fang. Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes  for Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, 200233, China

Corresponding author: LIU Fang, E-mail:f-liu@sjtu.edu.cn

[Summary] Bariatric-metabolic surgery has been listed as one of the new therapy strategies for type 2 diabetes mellitus (T2DM). Clinical practices have confirmed that metabolic surgery is an effective method for the remission of diabetes. Currently, bariatric-metabolic surgery has become one of the research hotspot. The hypothesis of mechanism involved in gut hormone alterations, adipose-pancreas islet axis reaction, inflammation modification and intestinal flora. In addition, metabolic surgery was demonstrated to have benefits on patients with pre-diabetes and polycystic ovary syndrome. Here is to review its mechanism advancement and clinical application based on post-surgery follow-up observations and laboratory evidences.

 [Key words]  Bariatric-Metabolic Surgery; Diabetes mellitus, Type 2;  Pre-Diabetes; Polycystic Ovary Syndrome(PCOS)