Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study
Background There are currently few pre-operative predictors of initial and long-term weight loss following bariatric surgery. Objectives We evaluated the role of pre-operative patient characteristics and baseline gut and adipose-derived hormones in predicting maximal total body weight loss (WL max )...
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| Veröffentlicht in: | Obesity surgery 2020-12, Vol.30 (12), p.4852-4859 |
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| creator | Aliakbarian, Hassan Bhutta, Hina Y. Heshmati, Keyvan Unes Kunju, Shebna Sheu, Eric G. Tavakkoli, Ali |
| description | Background
There are currently few pre-operative predictors of initial and long-term weight loss following bariatric surgery.
Objectives
We evaluated the role of pre-operative patient characteristics and baseline gut and adipose-derived hormones in predicting maximal total body weight loss (WL
max
) and risk of weight regain (WR) after Roux-en-Y gastric bypass (RYGB) surgery.
Methods
One hundred five adult patients undergoing primary RYGB were prospectively recruited. Baseline demographics were recorded and fasting plasma glucose, glycosylated hemoglobin (A1C), insulin, glucagon, leptin, active ghrelin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) levels were measured on day of surgery.
Results
Our cohort had a mean age of 44.4 ± 13.0 years, and initial BMI (body mass index) of 45.1 ± 6.7 kg/m
2
with mean post-operative follow-up of 40 months. Eighty patients were female and 26 had type 2 diabetes mellitus (T2D). Average WL
max
was 35.3 ± 7.4%. On univariate analysis, higher baseline fasting ghrelin, lower age, lower CRP (C-reactive protein), lower A1C, and negative T2D status were associated with greater WL
max
(
p
|
| doi_str_mv | 10.1007/s11695-020-04877-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2430369505</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2473256108</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-653fb8cd5658e8cc28269e1a289702acc0b92f19afe7cf72a145522d24a42c733</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0EokPhD7BAlth0Y3p9ncQOO6joQxoJ1IcQK8vj3AypMnGwk8Ks-tdrOi1ILFhZR_7OufY9jL2W8E4C6MMkZVWXAhAEFEZroZ-whdRgskTzlC2grkCYGtUee5HSNQDKCvE521OoC4OgFuz2SyQRRopu6m6IZ9V0fgox8dDyr9Stv098GVLibmge9TmtXTfw49D34Wc3rPl5mH8JGsQ3fuLSFDvPP25Hl00Xc1xT3L7nLieHNJK_n3I6b9zAL6a52b5kz1rXJ3r1cO6zq-NPl0enYvn55Ozow1L4opCTqErVroxvyqo0ZLxHg1VN0qGpNaDzHlY1trJ2LWnfanSyKEvEBgtXoNdK7bODXe4Yw4-Z0mQ3XfLU926gMCeLhQKVtwllRt_-g16HOQ75dZnSCstKgskU7iifP5YitXaM3cbFrZVgf9djd_XYXI-9r8fqbHrzED2vNtT8sTz2kQG1A1K-GvLu_s7-T-wdfDCapQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2473256108</pqid></control><display><type>article</type><title>Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Aliakbarian, Hassan ; Bhutta, Hina Y. ; Heshmati, Keyvan ; Unes Kunju, Shebna ; Sheu, Eric G. ; Tavakkoli, Ali</creator><creatorcontrib>Aliakbarian, Hassan ; Bhutta, Hina Y. ; Heshmati, Keyvan ; Unes Kunju, Shebna ; Sheu, Eric G. ; Tavakkoli, Ali</creatorcontrib><description>Background
There are currently few pre-operative predictors of initial and long-term weight loss following bariatric surgery.
Objectives
We evaluated the role of pre-operative patient characteristics and baseline gut and adipose-derived hormones in predicting maximal total body weight loss (WL
max
) and risk of weight regain (WR) after Roux-en-Y gastric bypass (RYGB) surgery.
Methods
One hundred five adult patients undergoing primary RYGB were prospectively recruited. Baseline demographics were recorded and fasting plasma glucose, glycosylated hemoglobin (A1C), insulin, glucagon, leptin, active ghrelin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) levels were measured on day of surgery.
Results
Our cohort had a mean age of 44.4 ± 13.0 years, and initial BMI (body mass index) of 45.1 ± 6.7 kg/m
2
with mean post-operative follow-up of 40 months. Eighty patients were female and 26 had type 2 diabetes mellitus (T2D). Average WL
max
was 35.3 ± 7.4%. On univariate analysis, higher baseline fasting ghrelin, lower age, lower CRP (C-reactive protein), lower A1C, and negative T2D status were associated with greater WL
max
(
p
< 0.05). Controlling for these variables using stepwise multivariate regression, only higher fasting ghrelin and younger age were associated significantly with greater WL
max
(
p
< 0.05). In subgroup multivariate regression analysis of T2D patients, higher ghrelin and glucagon were significantly associated with greater WL
max
. Following stepwise multivariate regression, lower initial BMI and lower glucagon were associated with greater WR (
p
< 0.05).
Conclusions
Incorporation of baseline biological and hormonal markers may help in developing more accurate predictive models for weight loss following bariatric surgery that help inform patient counseling and decision-making.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-020-04877-7</identifier><identifier>PMID: 32748203</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Female ; Gastric Bypass ; Gastrointestinal surgery ; Glucagon ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity, Morbid - surgery ; Original Contributions ; Patients ; Prospective Studies ; Surgery ; Weight Gain ; Weight Loss</subject><ispartof>Obesity surgery, 2020-12, Vol.30 (12), p.4852-4859</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-653fb8cd5658e8cc28269e1a289702acc0b92f19afe7cf72a145522d24a42c733</citedby><cites>FETCH-LOGICAL-c441t-653fb8cd5658e8cc28269e1a289702acc0b92f19afe7cf72a145522d24a42c733</cites><orcidid>0000-0002-7430-1848</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-020-04877-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-020-04877-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27902,27903,41466,42535,51296</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32748203$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aliakbarian, Hassan</creatorcontrib><creatorcontrib>Bhutta, Hina Y.</creatorcontrib><creatorcontrib>Heshmati, Keyvan</creatorcontrib><creatorcontrib>Unes Kunju, Shebna</creatorcontrib><creatorcontrib>Sheu, Eric G.</creatorcontrib><creatorcontrib>Tavakkoli, Ali</creatorcontrib><title>Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
There are currently few pre-operative predictors of initial and long-term weight loss following bariatric surgery.
Objectives
We evaluated the role of pre-operative patient characteristics and baseline gut and adipose-derived hormones in predicting maximal total body weight loss (WL
max
) and risk of weight regain (WR) after Roux-en-Y gastric bypass (RYGB) surgery.
Methods
One hundred five adult patients undergoing primary RYGB were prospectively recruited. Baseline demographics were recorded and fasting plasma glucose, glycosylated hemoglobin (A1C), insulin, glucagon, leptin, active ghrelin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) levels were measured on day of surgery.
Results
Our cohort had a mean age of 44.4 ± 13.0 years, and initial BMI (body mass index) of 45.1 ± 6.7 kg/m
2
with mean post-operative follow-up of 40 months. Eighty patients were female and 26 had type 2 diabetes mellitus (T2D). Average WL
max
was 35.3 ± 7.4%. On univariate analysis, higher baseline fasting ghrelin, lower age, lower CRP (C-reactive protein), lower A1C, and negative T2D status were associated with greater WL
max
(
p
< 0.05). Controlling for these variables using stepwise multivariate regression, only higher fasting ghrelin and younger age were associated significantly with greater WL
max
(
p
< 0.05). In subgroup multivariate regression analysis of T2D patients, higher ghrelin and glucagon were significantly associated with greater WL
max
. Following stepwise multivariate regression, lower initial BMI and lower glucagon were associated with greater WR (
p
< 0.05).
Conclusions
Incorporation of baseline biological and hormonal markers may help in developing more accurate predictive models for weight loss following bariatric surgery that help inform patient counseling and decision-making.</description><subject>Adult</subject><subject>Blood Glucose</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Female</subject><subject>Gastric Bypass</subject><subject>Gastrointestinal surgery</subject><subject>Glucagon</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Surgery</subject><subject>Weight Gain</subject><subject>Weight Loss</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtv1DAUhS0EokPhD7BAlth0Y3p9ncQOO6joQxoJ1IcQK8vj3AypMnGwk8Ks-tdrOi1ILFhZR_7OufY9jL2W8E4C6MMkZVWXAhAEFEZroZ-whdRgskTzlC2grkCYGtUee5HSNQDKCvE521OoC4OgFuz2SyQRRopu6m6IZ9V0fgox8dDyr9Stv098GVLibmge9TmtXTfw49D34Wc3rPl5mH8JGsQ3fuLSFDvPP25Hl00Xc1xT3L7nLieHNJK_n3I6b9zAL6a52b5kz1rXJ3r1cO6zq-NPl0enYvn55Ozow1L4opCTqErVroxvyqo0ZLxHg1VN0qGpNaDzHlY1trJ2LWnfanSyKEvEBgtXoNdK7bODXe4Yw4-Z0mQ3XfLU926gMCeLhQKVtwllRt_-g16HOQ75dZnSCstKgskU7iifP5YitXaM3cbFrZVgf9djd_XYXI-9r8fqbHrzED2vNtT8sTz2kQG1A1K-GvLu_s7-T-wdfDCapQ</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Aliakbarian, Hassan</creator><creator>Bhutta, Hina Y.</creator><creator>Heshmati, Keyvan</creator><creator>Unes Kunju, Shebna</creator><creator>Sheu, Eric G.</creator><creator>Tavakkoli, Ali</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7430-1848</orcidid></search><sort><creationdate>20201201</creationdate><title>Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study</title><author>Aliakbarian, Hassan ; Bhutta, Hina Y. ; Heshmati, Keyvan ; Unes Kunju, Shebna ; Sheu, Eric G. ; Tavakkoli, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-653fb8cd5658e8cc28269e1a289702acc0b92f19afe7cf72a145522d24a42c733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Blood Glucose</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Female</topic><topic>Gastric Bypass</topic><topic>Gastrointestinal surgery</topic><topic>Glucagon</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Surgery</topic><topic>Weight Gain</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aliakbarian, Hassan</creatorcontrib><creatorcontrib>Bhutta, Hina Y.</creatorcontrib><creatorcontrib>Heshmati, Keyvan</creatorcontrib><creatorcontrib>Unes Kunju, Shebna</creatorcontrib><creatorcontrib>Sheu, Eric G.</creatorcontrib><creatorcontrib>Tavakkoli, Ali</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aliakbarian, Hassan</au><au>Bhutta, Hina Y.</au><au>Heshmati, Keyvan</au><au>Unes Kunju, Shebna</au><au>Sheu, Eric G.</au><au>Tavakkoli, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>30</volume><issue>12</issue><spage>4852</spage><epage>4859</epage><pages>4852-4859</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
There are currently few pre-operative predictors of initial and long-term weight loss following bariatric surgery.
Objectives
We evaluated the role of pre-operative patient characteristics and baseline gut and adipose-derived hormones in predicting maximal total body weight loss (WL
max
) and risk of weight regain (WR) after Roux-en-Y gastric bypass (RYGB) surgery.
Methods
One hundred five adult patients undergoing primary RYGB were prospectively recruited. Baseline demographics were recorded and fasting plasma glucose, glycosylated hemoglobin (A1C), insulin, glucagon, leptin, active ghrelin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) levels were measured on day of surgery.
Results
Our cohort had a mean age of 44.4 ± 13.0 years, and initial BMI (body mass index) of 45.1 ± 6.7 kg/m
2
with mean post-operative follow-up of 40 months. Eighty patients were female and 26 had type 2 diabetes mellitus (T2D). Average WL
max
was 35.3 ± 7.4%. On univariate analysis, higher baseline fasting ghrelin, lower age, lower CRP (C-reactive protein), lower A1C, and negative T2D status were associated with greater WL
max
(
p
< 0.05). Controlling for these variables using stepwise multivariate regression, only higher fasting ghrelin and younger age were associated significantly with greater WL
max
(
p
< 0.05). In subgroup multivariate regression analysis of T2D patients, higher ghrelin and glucagon were significantly associated with greater WL
max
. Following stepwise multivariate regression, lower initial BMI and lower glucagon were associated with greater WR (
p
< 0.05).
Conclusions
Incorporation of baseline biological and hormonal markers may help in developing more accurate predictive models for weight loss following bariatric surgery that help inform patient counseling and decision-making.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32748203</pmid><doi>10.1007/s11695-020-04877-7</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7430-1848</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-8923 |
| ispartof | Obesity surgery, 2020-12, Vol.30 (12), p.4852-4859 |
| issn | 0960-8923 1708-0428 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2430369505 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Blood Glucose Diabetes Mellitus, Type 2 Female Gastric Bypass Gastrointestinal surgery Glucagon Humans Medicine Medicine & Public Health Middle Aged Obesity, Morbid - surgery Original Contributions Patients Prospective Studies Surgery Weight Gain Weight Loss |
| title | Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study |
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