East Asian perspectives in metabolic and bariatric surgery

• Published in: Journal of diabetes investigation 2022-05, Vol.13 (5), p.756-761
• Main Authors: Oh, Tae Jung, Lee, Hyuk‐Joon, Cho, Young Min
• Format: Article
• Language: English
• Subjects: Asian people; Asians; Bariatric Surgery; Body mass index; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - surgery; Gastrectomy; Gastric Bypass; Gastric cancer; Gastrointestinal surgery; Glucose; Health insurance; Homeostasis; Humans; Insulin resistance; Meta-analysis; Metabolism; Mini Review; Minority & ethnic groups; Nutrition; Obesity; Obesity, Morbid - surgery; Peptides; Remission; Remission (Medicine); Retrospective Studies; Stomach Neoplasms; Surgery; Treatment Outcome; Type 2 diabetes mellitus; Weight control; Weight Loss
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.13748

The prevalence of diabetes and obesity continues to rise in East Asia. As the risk of diabetes increases at a lower body mass index (BMI) in East Asians than in Europeans, the threshold of BMI values for metabolic and bariatric surgery (MBS) is lower in East Asians. MBS is considered upon reaching a BMI of 27.5 kg/m2 and is recommended at a BMI of ≥ 32.5 kg/m2, depending on the status of glucose homeostasis. The most commonly performed MBS in East Asia is sleeve gastrectomy, followed by Roux‐en‐Y gastric bypass (RYGB). Because the incidence of gastric cancer is higher in East Asia than in other regions, concerns regarding surveillance for gastric cancer might be related to a preference for sleeve gastrectomy over RYGB in this region. Even though there is a paucity of data on direct comparisons of the efficacy of MBS among different ethnic groups, the degree of weight reduction in East Asians is not inferior to other ethnic groups. Moreover, studies suggest that the diabetes remission rate in East Asians seemed to be higher than in other ethnic groups. Future studies involving multiethnic groups are necessary to identify possible ethnic differences in diabetes remission and to determine the appropriate BMI threshold for MBS according to ethnicity. Metabolic and bariatric surgery is a good option for the management of diabetes and obesity in East Asians. Further studies are necessary to identify the appropriate body mass index cutoff threshold considering ethnic difference.