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Jiang YM, Zhong Q, Shang-Guan ZX, Lin GT, Guo XJ, Huang ZN, Lu J, Huang CM, Lin JX, Zheng CH. Fat Mass Index Predicts the Effect of Weight Loss and Quality of Life Early After Laparoscopic Sleeve Gastrectomy. Obes Surg 2024:10.1007/s11695-024-07518-5. [PMID: 39340581 DOI: 10.1007/s11695-024-07518-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 08/07/2024] [Accepted: 09/21/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND Fat mass index (FMI) is a body composition indicator that reflects body fat content. Laparoscopic sleeve gastrectomy (LSG) is widely performed in patients with obesity. OBJECTIVE This study aimed to evaluate the value of the FMI in predicting weight loss effect and quality of life early after LSG. MATERIAL AND METHODS From January 2014 to July 2022, the clinical data and computed tomography (CT) images of patients who underwent LSG at a tertiary referral teaching hospital were analyzed. Body composition indicators were calculated using the SliceOmatic software. Achieving initial body mass index within 6 months postoperatively was defined as early eligible weight loss (EEWL). The relationship between body composition and EEWL was analyzed. RESULTS A total of 243 patients were included. Receiver operating characteristic (ROC) curve analysis showed that the predictive value of the FMI for EEWL in patients after LSG was higher than that of other indicators (all P < 0.05; area under the curve = 0.813). The best FMI cut-off point was 13.662. Accordingly, the patients were divided into the high-FMI group and low-FMI group. The %EWL and BMI of patients in the low-FMI group at 1, 3, 6, 9, 12, and 24 months after surgery were better than those in the high-FMI group (all P < 0.001). Patients in the low-FMI group had higher BAROS (Bariatric Analysis and Reporting Outcome System) scores than those in the high-FMI group (P < 0.001). CONCLUSION Compared with other body composition indicators, FMI can effectively predict the early effect of weight loss and quality of life after LSG.
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Affiliation(s)
- Yi-Ming Jiang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Qing Zhong
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Zhi-Xin Shang-Guan
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Guang-Tan Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Xiao-Jing Guo
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Ze-Ning Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Jun Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Chang-Ming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
- Fujian Medical University, Fuzhou, China.
| | - Jian-Xian Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
- Fujian Medical University, Fuzhou, China.
| | - Chao-Hui Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
- Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
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Molero J, Olbeyra R, Flores L, Jiménez A, de Hollanda A, Andreu A, Ibarzabal A, Moizé V, Cañizares S, Balibrea JM, Obach A, Vidal J. Prevalence of low skeletal muscle mass following bariatric surgery. Clin Nutr ESPEN 2022; 49:436-441. [PMID: 35623849 DOI: 10.1016/j.clnesp.2022.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Evidence on the occurrence of low skeletal muscle mass (low-SMM) following bariatric surgery (BS) as well as on the impact of low-SMM antedating BS on post-surgical body composition (BC) are scant. In this context, we aimed to prospectively evaluate the prevalence of low-SMM prior to and up to 5 years after BS, and to evaluate pre-surgical low-SMM as an independent risk factor for the presence of low-SMM after BS. METHODS Retrospective analysis of prospectively collected database. BC was assessed by bioelectrical impedance analysis (BIA). A BIA-based formula was used to calculate skeletal muscle mass (SMM). Class I and class II low-SMM were defined respectively as a SMM index (SMMI = SMM/height2) value between -1 and -2, or > -2 standard deviations from the gender-specific regression line of the BMI versus the SMMI relationship in our reference group. RESULTS A total 952 subjects were included, with BC being available for 877 (92%) subjects at 12 months and for 576 subjects (60%) at 60 months after BS. Prior to surgery, and at 12-, or at 60-months after surgery, class I and class II low-SMM was ascertained respectively in 15.6% and 4.6%, 5.3% and 1.4%, and 16.6% and 6.3% of the study participants. Logistic regression analysis showed that the occurrence of low-SMM at 12- and 60-months follow-up, was independently predicted not only by age at the time of surgery [respectively, HR: 1.052 (95% CI 1.020-1.084), p = 0.001; and 1.042 (95% CI 1.019-1.066); p < 0.001] but also by the presence of low-SMM prior to surgery [respectively, HR: 10.717 (95% CI 5.771-19.904), p < 0.001; and 5.718 (95% CI 3.572-9.153); p < 0.001]. CONCLUSIONS Our data suggest that a low-SMM phenotype occurs not only in obesity surgery candidates but also after BS, and that low-SMM prior to surgery is an important risk factor for low-SMM throughout post-surgical follow-up.
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Affiliation(s)
- Judith Molero
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Romina Olbeyra
- Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Lilliam Flores
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain
| | - Amanda Jiménez
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de La Obesidad y Nutrición (CIBEROBN), Spain
| | - Ana de Hollanda
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de La Obesidad y Nutrición (CIBEROBN), Spain
| | - Alba Andreu
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de La Obesidad y Nutrición (CIBEROBN), Spain
| | - Ainitze Ibarzabal
- Gastrointestinal Surgery Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Violeta Moizé
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain
| | - Sílvia Cañizares
- Department of Clinical Psychology and Psychobiology, Section of Clinical Health Psychology, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - José María Balibrea
- Gastrointestinal Surgery Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Amadeu Obach
- Department of Clinical Psychology and Psychobiology, Section of Clinical Health Psychology, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Josep Vidal
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
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3
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Bacelar GB, Sampaio EF, Alcântara W, Lustoza JG, Daltro C, Daltro C. How to Diagnose Sarcopenic Obesity in Candidates for Bariatric Surgery? Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2021.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gabriela B. Bacelar
- Graduate Program in Medicine and Health, Faculty of Medicine of Bahia, Federal University of Bahia, Salvador Bahia and Núcleo de Tratamento e Cirurgia da Obesidade - NTCO, Salvador, Bahia, Brazil
| | | | - Wagno Alcântara
- Nutrition School, Federal University of Bahia, Salvador, Brazil
| | | | - Cláudia Daltro
- Graduate Program in Medicine and Health, Faculty of Medicine of Bahia, Federal University of Bahia, Salvador Bahia and Núcleo de Tratamento e Cirurgia da Obesidade - NTCO, Salvador, Bahia, Brazil
| | - Carla Daltro
- Graduate Program in Medicine and Health, Faculty of Medicine of Bahia, Federal University of Bahia, Salvador Bahia and Núcleo de Tratamento e Cirurgia da Obesidade - NTCO, Salvador, Bahia, Brazil
- Nutrition School, Federal University of Bahia, Salvador, Brazil
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Abstract
PURPOSE OF THE REVIEW To update the recent findings on the influence of personality features on postoperative weight loss in patients undergoing bariatric surgery. RECENT FINDINGS Several studies investigated the influence of pre-surgical psychological variables on the outcome of bariatric surgery, but the effective role of personality factors (i.e., both normal personality traits and personality disturbances) in shaping bariatric surgery outcome is still unclear. We analyzed nine recent papers that examined the impact of pre-operative personality traits on postoperative weight loss among individuals undergoing surgery for severe obesity. A personality pattern denoting the ability to self-regulate in spite of the urges or demands of the moment emerged as a robust predictor of good outcome across studies, independently from baseline psychiatric comorbidity and personality disorders.
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Affiliation(s)
- Irene Generali
- School of Psychiatry, Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43126, Parma, Italy.
| | - Chiara De Panfilis
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
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Eckstein ML, Lawrence JB, Otto C, Kotsch P, Messerschmidt J, Bracken RM, Moser O. Impairments of postural control, functional performance and strength in morbidly obese patients awaiting bariatric surgery in comparison to healthy individuals. J Phys Ther Sci 2018; 30:663-668. [PMID: 29765176 PMCID: PMC5940468 DOI: 10.1589/jpts.30.663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/05/2018] [Indexed: 12/05/2022] Open
Abstract
[Purpose] There is a lack of information evaluating specific markers of performance in
patients awaiting bariatric surgery. We aimed to assess the postural control, functional
performance, strength and endurance performance for morbidly obese patients awaiting
bariatric surgery compared to lean controls. [Subjects and Methods] All parameters were
assessed by modified Y-balance test, timed-up-and-go-test, maximum strength testing on
resistance exercise equipment and cardio-pulmonary exercise testing on a cycle ergometer
in 10 morbidly obese patients awaiting bariatric surgery and 10 age- and sex-matched lean
controls. [Results] It was found that significant differences existed for overall modified
Y-balance test in morbidly obese patients awaiting bariatric surgery versus lean controls
(0.37 ± 0.03 vs. 0.47 ± 0.02 cm.cm−1), timed-up-and-go-test (9.33 ± 1.23 vs.
7.85 ± 1.73 sec) and several variables of cardio-pulmonary exercise testing. Overall
absolute strength expressed in kilogram was similar, yet when relativized to body weight
strength differences were notable (0.4 ± 0.17 vs. 0.83 ± 0.32 kg.kg−1).
[Conclusion] The results of this study demonstrate the need for comprehensive functional
assessment prior to surgery with an identified demand for subsequent tailored physical
training prescription that should begin before surgery.
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Affiliation(s)
- Max Lennart Eckstein
- Diabetes Research Group, Medical School, Swansea University: SA2 8PP Swansea, Singleton Park, Wales, United Kingdom.,Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, United Kingdom.,University Outpatient Clinic, Center of Sports Medicine & Sports Orthopedics, University of Potsdam, Germany
| | - Jimmy Bradley Lawrence
- University Outpatient Clinic, Center of Sports Medicine & Sports Orthopedics, University of Potsdam, Germany
| | - Christoph Otto
- University Outpatient Clinic, Center of Sports Medicine & Sports Orthopedics, University of Potsdam, Germany.,Fritz Stephan GmbH, Germany
| | - Peggy Kotsch
- University Outpatient Clinic, Center of Sports Medicine & Sports Orthopedics, University of Potsdam, Germany
| | - Janin Messerschmidt
- University Outpatient Clinic, Center of Sports Medicine & Sports Orthopedics, University of Potsdam, Germany.,Department of Medicine II, Department of Hematology, University Hospital Wuerzburg, Germany
| | - Richard Michael Bracken
- Diabetes Research Group, Medical School, Swansea University: SA2 8PP Swansea, Singleton Park, Wales, United Kingdom.,Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, United Kingdom
| | - Othmar Moser
- Diabetes Research Group, Medical School, Swansea University: SA2 8PP Swansea, Singleton Park, Wales, United Kingdom.,Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, United Kingdom.,University Outpatient Clinic, Center of Sports Medicine & Sports Orthopedics, University of Potsdam, Germany
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6
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Doležalova-Kormanova K, Buchwald JN, Skochova D, Pichlerova D, McGlennon TW, Fried M. Five-Year Outcomes: Laparoscopic Greater Curvature Plication for Treatment of Morbid Obesity. Obes Surg 2018; 27:2818-2828. [PMID: 28560523 DOI: 10.1007/s11695-017-2709-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Laparoscopic greater curvature plication (LGCP) is a newer metabolic/bariatric surgical procedure that requires no resection, bypass, or implantable device. We report outcomes in a cohort of LGCP patients at 5-year follow-up. METHODS Body mass index (BMI, kg/m2) evolution, excess weight loss (%EWL), excess BMI loss (%EBMIL), and total weight loss (%TWL) were recorded. Repeated measures analysis of variance (ANOVA) was used to assess BMI change over 5 years. Two-step cluster analysis was used to profile LGCP patients according to significant characteristics relative to successful 5-year weight loss. RESULTS Of patients entering the study between 2010 and 2011 with complete weight data through 5-year follow-up (86.9%, 212/244), mean age was 45.8 ± 10.9 years; mean baseline BMI, 41.4 ± 5.5 (81.6% women); 58 patients (27.4%) had type 2 diabetes. Mean operative time was 69.0 min; mean hospitalization, 38 h (24-72). ANOVA indicated a significant BMI reduction out to 2 years (p < 0.001), a plateau at 3 and 4 years, and a moderate but significant BMI increase at 5 years (p < 0.01). EBMIL at 1, 2, 3, 4, and 5 years was as follows: 50.7 ± 9.1%, 61.5 ± 8.1%, 60.2 ± 7.0%, 58.5 ± 7.0%, and 56.8 ± 6.3%. At 5 years, 79.2% (168/212) of patients were successful; 20.8% (44/212) experienced a suboptimal weight outcome; mean weight regain, 9.2%. Cluster analysis identified four distinct LGCP patient profiles. Diabetes improvement rate was 65.5%. There were 12 reoperations (4.9%): 4 emergency (1.6%) and 8 (3.3%) elective. There was no mortality. CONCLUSIONS At 5-year follow-up, LGCP proved to be safe and effective, with 56.8% EBMIL and a low rate of complications.
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Affiliation(s)
- K Doležalova-Kormanova
- First Faculty of Medicine, Charles University, Prague, Czech Republic.
- OB Klinika a.s, Pod Krejcarkem 975, 130 00, Prague 3, Czech Republic.
| | - J N Buchwald
- Division of Scientific Research Writing, Medwrite Medical Communications, Maiden Rock, WI, USA
| | - D Skochova
- General University Hospital, Prague, and Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic
| | - D Pichlerova
- OB Klinika a.s, Pod Krejcarkem 975, 130 00, Prague 3, Czech Republic
| | - T W McGlennon
- Statistical Analysis and Quality of Life Assessment, McGlennon MotiMetrics, Maiden Rock, WI, USA
| | - M Fried
- First Faculty of Medicine, Charles University, Prague, Czech Republic
- OB Klinika a.s, Pod Krejcarkem 975, 130 00, Prague 3, Czech Republic
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7
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Hindle A, de la Piedad Garcia X, Brennan L. Early post-operative psychosocial and weight predictors of later outcome in bariatric surgery: a systematic literature review. Obes Rev 2017; 18:317-334. [PMID: 28170168 DOI: 10.1111/obr.12496] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/10/2016] [Accepted: 11/23/2016] [Indexed: 01/18/2023]
Abstract
This is the first systematic review to synthesize the evidence concerning early post-operative variables predictive of later weight and psychosocial outcomes in bariatric surgery. Eight electronic databases for empirical studies were searched (1954 to 2016). Most of the 39 included studies reported solely on weight outcomes; eating and psychosocial outcomes were less common. A better early weight loss trajectory was the most consistent predictor of more successful medium-term weight outcome (≤24 months); however, its relationship to longer term weight loss maintenance is less certain. Early eating adaptation may be associated with later weight loss, but further research is needed. Evidence is lacking for associations between early adherence or early psychosocial variables and later outcome. In particular, the relationship between early post-operative depression and later weight remains unclear. Little research has considered early prediction of later eating or psychosocial outcomes. Consideration of mediating or moderating relationships is lacking. The body of evidence is limited, and synthesis is hampered by heterogeneity in the type and time at which predictors and outcomes are measured and quality of statistical reporting. Further research on prospective prediction of bariatric surgery outcome is needed to guide early post-operative intervention for those at greatest risk of poor outcomes.
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Affiliation(s)
- A Hindle
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - X de la Piedad Garcia
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - L Brennan
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
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Schaaf C, Gugenheim J. Impact of Preoperative Serum Vitamin D Level on Postoperative Complications and Excess Weight Loss After Gastric Bypass. Obes Surg 2017; 27:1982-1985. [PMID: 28210963 DOI: 10.1007/s11695-017-2600-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The aim of this study was to determine the impact of hypovitaminosis D on Gastric Bypass outcomes. METHODS We retrospectively reviewed all patients who underwent primary intention Gastric Bypass in our center between January 2012 and December 2013. Postoperative complications, 1 and 2-year excess weight loss were compared between patients with and without hypovitaminosis D. RESULTS Among 258 patients who met inclusion criteria, 56 (21.7%) presented with vitamin D deficiency. Mean age was 41.73 ± 12.95 years. Mean BMI was 40.90 kg/m2 (34-58 kg/m2). No statistically significant difference in postoperative complication rate was found between patients with and without hypovitaminosis D. Mean 1-year excess weight loss was 75.24%. In patients with vitamin D deficiency mean 1-year excess weight loss was 71.90 versus 76.15% in patients with optimal serum vitamin D level (p = 0.17). No significant difference was found after a 2-year follow-up. In patients presenting with vitamin D insufficiency, 1-year excess weight loss was 75.64 versus 79.34% in patients with optimal serum vitamin D level (p = 0.53). After a 2-year follow-up, there was a significant difference between patients presenting with and without vitamin D insufficiency (79.45 versus 91.71%; p = 0.01) and between patients presenting with and without hypovitaminosis D (80.50 versus 91.71%; p = 0.01). CONCLUSION In our study, hypovitaminosis D seemed to have a negative impact on long term excess weight loss, but not on short-term outcome or postoperative complications. The role of systematic supplementation before bariatric surgery has to be explored in prospective studies.
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Affiliation(s)
- Caroline Schaaf
- Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet 2, Centre Hospitalo Universitaire, Université de Nice Sophia Antipolis, Nice, France.
| | - Jean Gugenheim
- Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet 2, Centre Hospitalo Universitaire, Université de Nice Sophia Antipolis, Nice, France
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9
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Palmisano S, Silvestri M, Giuricin M, Baldini E, Albertario S, Capelli P, Marzano B, Fanti G, Zompicchiatti A, Millo P, Fabozzi M, Brachet Contul R, Ponte E, Allieta R, de Manzini N. Preoperative Predictive Factors of Successful Weight Loss and Glycaemic Control 1 Year After Gastric Bypass for Morbid Obesity. Obes Surg 2016; 25:2040-6. [PMID: 25845353 DOI: 10.1007/s11695-015-1662-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Gastric bypass (GBP) is one of the most effective surgical procedures to treat morbid obesity and the related comorbidities. This study aimed at identifying preoperative predictors of successful weight loss and type 2 diabetes mellitus (T2DM) remission 1 year after GBP. METHODS Prospective longitudinal study of 771 patients who underwent GBP was performed at four Italian centres between November 2011 and May 2013 with 1-year follow-up. Preoperative anthropometric, metabolic and social parameters, the surgical technique and the previous failed bariatric procedures were analyzed. Weight, the body mass index (BMI), the percentage of excess weight lost (% EWL), the percentage of excess BMI lost (% BMIL) and glycated haemoglobin (HbA1c) were recorded at follow-up. RESULTS Univariate and multivariate analysis showed that BMI <50 kg/m(2) (p = 0.006) and dyslipidaemia (p = 0.05) were predictive factors of successful weight loss. Multivariate analysis of surgical technique showed significant weight loss in patients with a small gastric pouch (p < 0.001); the lengths of alimentary and biliary loops showed no statistical significance. All diabetic patients had a significant reduction of HbA1c (p < 0.001) after surgery. BMI ≥ 50 kg/m(2) (p = 0.02) and low level of preoperative HbA1c (p < 0.01) were independent risk factors of T2DM remission after surgery. CONCLUSIONS This study provides a useful tool for making more accurate predictions of best results in terms of weight loss and metabolic improvement.
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Affiliation(s)
- Silvia Palmisano
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy.
| | - Marta Silvestri
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy.
| | - Michela Giuricin
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy.
| | - Edoardo Baldini
- Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy.
| | - Simone Albertario
- Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy.
| | - Patrizio Capelli
- Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy.
| | - Bernardo Marzano
- Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy.
| | - Giovanni Fanti
- Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy.
| | - Aron Zompicchiatti
- Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy.
| | - Paolo Millo
- Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy.
| | - Massimiliano Fabozzi
- Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy.
| | - Riccardo Brachet Contul
- Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy.
| | - Elisa Ponte
- Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy.
| | - Rosaldo Allieta
- Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy.
| | - Nicolò de Manzini
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy.
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11
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Robert M, Pechoux A, Marion D, Laville M, Gouillat C, Disse E. Relevance of Roux-en-Y gastric bypass volumetry using 3-dimensional gastric computed tomography with gas to predict weight loss at 1 year. Surg Obes Relat Dis 2014; 11:26-31. [PMID: 25500226 DOI: 10.1016/j.soard.2014.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 04/21/2014] [Accepted: 05/18/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND Causes of Roux-en-Y gastric bypass (RYGB) failures are still controversial. Literature data suggest that gastric pouch or gastrojejunal anastomosis distentions over time could be a key factor. Making the hypothesis that progressive distention of RYGB volumes is 1 of the main factors of weight loss failure, the aim of our study was to evaluate bypass volumes changes using repeated 3-dimensional gastric computed tomography with gas and the possible negative correlation with weight loss results at 1 year. METHODS Thirty-nine patients eligible for RYGB were prospectively included. Gastric bypass volumes were assessed at 3 and 12 months postsurgery performing 3-dimensional gastric computed tomography with gas and weight loss outcomes were recorded during the first postoperative year. RESULTS There was no loss to follow up. Mean % excess body mass index lost (%EBMIL) at 1 year was 66.7%. Seven patients (17.9%) did not reach Reinhold criteria and were considered as RYGB failures. We found no linear correlation between the 1 year %EBMIL and mean values of the gastric pouch (r=.01; P=.94), and the neo stomach (r=.09 ; P=.57) at 3 months. Revisional surgery was correlated negatively with %EBMIL at 1 year. CONCLUSION Weight loss at 1 year does not seem to be correlated to RYGB volume changes. Behavioral factors probably play a major role in weight loss failure.
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Affiliation(s)
- Maud Robert
- Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, F69437, Lyon cedex 03, France; Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France.
| | - Albane Pechoux
- Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, F69437, Lyon cedex 03, France
| | - Denis Marion
- Department of Radiology, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France
| | - Martine Laville
- Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France; Department of Endocrinology, Diabetology and Nutrition, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France
| | - Christian Gouillat
- Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, F69437, Lyon cedex 03, France; Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Emmanuel Disse
- Centre Intégré et Spécialisé de L'Obésité de Lyon, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, Lyon, France; Department of Endocrinology, Diabetology and Nutrition, Groupement Hospitalier Lyon Sud, Hospices Civils de Lyon, F69495 Pierre Bénite, France
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