Improvement of diabetes and hypertension after gastrectomy: A nationwide cohort study

Table 1 Baseline characteristics of diabetic patients n (%)

	Endoscopic resection (n = 85)	Subtotal gastrectomy (n = 218)	Total gastrectomy (n = 57)	P
Male	39 (45.9)	142 (65.1)	40 (70.2)	0.0031
Age at treatment (yr, mean ± SE)	64.9 ± 7.4	65.1 ± 8.7	64.1 ± 8.5	0.74
Comorbid HTN	57 (67.1)	120 (55.0)	29 (50.9)	0.09
Diabetes medication
Sulfonylurea (S)	72 (84.7)	178 (81.7)	47 (82.5)	0.82
Metformin (M)	42 (49.4)	126 (57.8)	30 (52.6)	0.39
α-glucosidase inhibitor	20 (23.5)	45 (20.6)	19 (33.3)	0.13
Thiazolidinedione (T)	8 (9.4)	16 (7.3)	1 (1.8)	0.20
Insulin	54 (63.5)	181 (83.0)	47 (82.5)	0.0011
Combination (M, S)	3 (3.5)	5 (2.3)	2 (3.5)	0.73
Combination (M, T)	1 (1.2)	2 (0.9)	0 (0.0)	1.00
Others	1 (1.2)	9 (4.1)	1 (1.8)	0.48
Diabetes medications (n)
1	12 (14.1)	22 (10.1)	6 (10.5)	0.24
2	38 (44.7)	79 (36.2)	23 (40.4)
3	25 (29.4)	85 (39.0)	15 (26.3)
≥ 4	10 (11.8)	32 (14.7)	13 (22.8)

¹P-value by χ² test. HTN: Hypertension.

Table 2 Baseline characteristics of hypertensive patients n (%)

	Endoscopic resection (n = 53)	Subtotal gastrectomy (n = 244)	Total gastrectomy (n = 54)	P
Male	36 (67.9)	153 (62.7)	41 (75.9)	0.17
Age at treatment (yr, mean ± SE)	65.2 ± 8.1	65.8 ± 8.5	66.3 ± 9.3	0.79
Comorbid DM	5 (9.4)	46 (18.9)	13 (24.1)	0.13
Cardiovascular medication
Lipid lowering agent	8 (15.1)	52 (21.3)	13 (24.1)	0.49
Antithrombotic agent	22 (41.5)	93 (38.1)	22 (40.7)	0.87
Other	1 (1.9)	5 (2.0)	2 (3.7)	0.85
Antihypertensive agent
Calcium channel blocker (C)	41 (77.4)	166 (68.0)	33 (61.1)	0.19
Diuretics (D)	19 (35.8)	92 (37.7)	21 (38.9)	0.95
Beta-blocker (B)	19 (35.8)	76 (31.1)	17 (31.5)	0.80
ACEi or ARB (A)	15 (28.3)	82 (33.6)	18 (33.3)	0.75
Combination (A, D)	9 (17.0)	41 (16.8)	5 (9.3)	0.37
Combination (B, D)	0 (0.0)	9 (3.7)	1 (1.9)	0.54
Combination (A, C)	0 (0.0)	6 (2.5)	3 (5.6)	0.19
Antihypertensive medications (n)
1	18 (33.3)	73 (29.9)	16 (30.2)	0.70
2	25 (46.3)	97 (39.8)	22 (41.5)
≥ 3	11 (20.4)	74 (30.3)	15 (28.3)

ACEi: Angiotensin-converting enzyme inhibitor; ARB: Angiotensin receptor blocker; DM: Diabetes mellitus.

Table 3 Age and sex-adjusted hazard ratios for discontinuation and resumption of anti-diabetics or anti-hypertensive by treatment methods

Prescription history	Diabetic patients		Hypertensive patients
	HR	95%CI	HR	95%CI
Discontinuation
Endoscopic resection	1.00		1.00
Subtotal gastrectomy	0.70	0.29-1.71	1.01	0.41-2.46
Total gastrectomy	2.87a	1.15-7.17	0.63	0.18-2.27
Resumption
Endoscopic resection	1.00		1.00
Subtotal gastrectomy	5.21a	1.64-16.60	2.19	0.65-7.39
Total gastrectomy	0.93	0.31-2.79	1.10	0.23-5.17

^aP < 0.05 vs other groups. Adjusted by sex, age, coexistence of each disease.