High Prevalence of Positive Genetic Obesity Variants in Postoperative Bariatric Surgery Patients with Weight Regain Presenting for Medical Obesity Intervention
Introduction Genetic obesity susceptibility in postoperative bariatric surgery weight regain (PBSWR) remains largely unexplored. Methods A retrospective case series of adult ( N = 27) PBSWR patients who had undergone genetic obesity testing was conducted between Sept. 2020 and March 2022. Primary o...
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| Veröffentlicht in: | Obesity surgery 2024, Vol.34 (1), p.170-175 |
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| creator | Samuels, Jason M. Paddu, Nina U. Rekulapeli, Akhil Madhar, Ayush Srivastava, Gitanjali |
| description | Introduction
Genetic obesity susceptibility in postoperative bariatric surgery weight regain (PBSWR) remains largely unexplored.
Methods
A retrospective case series of adult (
N
= 27) PBSWR patients who had undergone genetic obesity testing was conducted between Sept. 2020 and March 2022. Primary outcome: frequency of genetic variants in patients experiencing weight regain following bariatric surgery. Secondary outcomes: prevalence of obesity-related comorbidities, nadir BMI achieved post-bariatric surgery, and percent total body weight loss (%TBWL) achieved with obesity pharmacotherapies.
Results
Heterozygous mutations were identified in 22 (81%) patients, with the most prevalent mutations occurring in CEP290, RPGR1P1L, and LEPR genes (3 patients each). Median age was 56 years (interquartile range (IQR) 46.8–65.5), 88% female. Types of surgery were 67% RYGB, 19% SG, 4% gastric band, and 13% revisions. Median nadir BMI postoperatively was 34.0 kg/m
2
(IQR 29.0–38.5). A high prevalence of metabolic derangements was noted; patients presented median 80 months (IQR 39–168.5) postoperative for medical weight management with 40% weight regain. BMI at initiation of anti-obesity medication (AOMs) was 41.7 kg/m
2
(36.8–44.4). All received AOM and required at least 3 AOMs for weight regain. Semaglutide (
N
= 21), topiramate (
N
= 14), and metformin (
N
= 12) were most prescribed. Median %TBWL for the cohort at the first, second, and third visit was 1.7, 5.0, and 6.5 respectively. Fourteen (52%) achieved 5%TBWL, 10 (37%) achieved 10%TBWL, and 4 (15%) achieved 15%TBWL with combination AOMs and supervised medical intervention.
Conclusion
An unusually high prevalence of genetic obesity variants in PBSWR was found, warranting further research.
Graphical Abstract |
| doi_str_mv | 10.1007/s11695-023-06952-1 |
| format | Article |
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Genetic obesity susceptibility in postoperative bariatric surgery weight regain (PBSWR) remains largely unexplored.
Methods
A retrospective case series of adult (
N
= 27) PBSWR patients who had undergone genetic obesity testing was conducted between Sept. 2020 and March 2022. Primary outcome: frequency of genetic variants in patients experiencing weight regain following bariatric surgery. Secondary outcomes: prevalence of obesity-related comorbidities, nadir BMI achieved post-bariatric surgery, and percent total body weight loss (%TBWL) achieved with obesity pharmacotherapies.
Results
Heterozygous mutations were identified in 22 (81%) patients, with the most prevalent mutations occurring in CEP290, RPGR1P1L, and LEPR genes (3 patients each). Median age was 56 years (interquartile range (IQR) 46.8–65.5), 88% female. Types of surgery were 67% RYGB, 19% SG, 4% gastric band, and 13% revisions. Median nadir BMI postoperatively was 34.0 kg/m
2
(IQR 29.0–38.5). A high prevalence of metabolic derangements was noted; patients presented median 80 months (IQR 39–168.5) postoperative for medical weight management with 40% weight regain. BMI at initiation of anti-obesity medication (AOMs) was 41.7 kg/m
2
(36.8–44.4). All received AOM and required at least 3 AOMs for weight regain. Semaglutide (
N
= 21), topiramate (
N
= 14), and metformin (
N
= 12) were most prescribed. Median %TBWL for the cohort at the first, second, and third visit was 1.7, 5.0, and 6.5 respectively. Fourteen (52%) achieved 5%TBWL, 10 (37%) achieved 10%TBWL, and 4 (15%) achieved 15%TBWL with combination AOMs and supervised medical intervention.
Conclusion
An unusually high prevalence of genetic obesity variants in PBSWR was found, warranting further research.
Graphical Abstract</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-023-06952-1</identifier><identifier>PMID: 37996769</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Anti-Obesity Agents - therapeutic use ; Bariatric Surgery ; Female ; Gastrointestinal surgery ; Genetics ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mutation ; Obesity ; Obesity - epidemiology ; Obesity - genetics ; Obesity - surgery ; Obesity, Morbid - surgery ; Original Contributions ; Prevalence ; Retrospective Studies ; Surgery ; Surgical outcomes ; Treatment Outcome ; Weight control ; Weight Gain</subject><ispartof>Obesity surgery, 2024, Vol.34 (1), p.170-175</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-6a1030a379bb48f5351d3f571c71b2183728729cbdba09c60d3d98f57457aafa3</citedby><cites>FETCH-LOGICAL-c375t-6a1030a379bb48f5351d3f571c71b2183728729cbdba09c60d3d98f57457aafa3</cites><orcidid>0000-0002-8326-3089</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/s11695-023-06952-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-023-06952-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37996769$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Samuels, Jason M.</creatorcontrib><creatorcontrib>Paddu, Nina U.</creatorcontrib><creatorcontrib>Rekulapeli, Akhil</creatorcontrib><creatorcontrib>Madhar, Ayush</creatorcontrib><creatorcontrib>Srivastava, Gitanjali</creatorcontrib><title>High Prevalence of Positive Genetic Obesity Variants in Postoperative Bariatric Surgery Patients with Weight Regain Presenting for Medical Obesity Intervention</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Introduction
Genetic obesity susceptibility in postoperative bariatric surgery weight regain (PBSWR) remains largely unexplored.
Methods
A retrospective case series of adult (
N
= 27) PBSWR patients who had undergone genetic obesity testing was conducted between Sept. 2020 and March 2022. Primary outcome: frequency of genetic variants in patients experiencing weight regain following bariatric surgery. Secondary outcomes: prevalence of obesity-related comorbidities, nadir BMI achieved post-bariatric surgery, and percent total body weight loss (%TBWL) achieved with obesity pharmacotherapies.
Results
Heterozygous mutations were identified in 22 (81%) patients, with the most prevalent mutations occurring in CEP290, RPGR1P1L, and LEPR genes (3 patients each). Median age was 56 years (interquartile range (IQR) 46.8–65.5), 88% female. Types of surgery were 67% RYGB, 19% SG, 4% gastric band, and 13% revisions. Median nadir BMI postoperatively was 34.0 kg/m
2
(IQR 29.0–38.5). A high prevalence of metabolic derangements was noted; patients presented median 80 months (IQR 39–168.5) postoperative for medical weight management with 40% weight regain. BMI at initiation of anti-obesity medication (AOMs) was 41.7 kg/m
2
(36.8–44.4). All received AOM and required at least 3 AOMs for weight regain. Semaglutide (
N
= 21), topiramate (
N
= 14), and metformin (
N
= 12) were most prescribed. Median %TBWL for the cohort at the first, second, and third visit was 1.7, 5.0, and 6.5 respectively. Fourteen (52%) achieved 5%TBWL, 10 (37%) achieved 10%TBWL, and 4 (15%) achieved 15%TBWL with combination AOMs and supervised medical intervention.
Conclusion
An unusually high prevalence of genetic obesity variants in PBSWR was found, warranting further research.
Graphical Abstract</description><subject>Adult</subject><subject>Anti-Obesity Agents - therapeutic use</subject><subject>Bariatric Surgery</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>Genetics</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>Obesity</subject><subject>Obesity - epidemiology</subject><subject>Obesity - genetics</subject><subject>Obesity - surgery</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Weight control</subject><subject>Weight Gain</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1u1DAUhS0EosPAC7BAltiwCb22kzheQgVtpVYd8bu0HOdm6irjDLYzaJ6GV8XplCJ1UcmSrXu-e67tQ8hrBu8ZgDyOjNWqKoCLAvKBF-wJWTAJTQElb56SBagaikZxcURexHgDwFnN-XNyJKRStazVgvw5c-trugq4MwN6i3Ts6WqMLrkd0lP0mJylVy3myp7-MMEZnyJ1fobSuMVgbsmPs5JCZr9OYY1hT1dZwJn97dI1_Yl5TKJfcG3m3oAxa86vaT8Geomds2a4H3PuE4bdDIz-JXnWmyHiq7t9Sb5__vTt5Ky4uDo9P_lwUVghq1TUhoEAk9_VtmXTV6JinegryaxkLWeNkLyRXNm2aw0oW0MnOpU5WVbSmN6IJXl38N2G8deEMemNixaHwXgcp6h5o0QjyhrKjL59gN6MU_D5dporxhUwkdeS8ANlwxhjwF5vg9uYsNcM9ByfPsSnc3z6Nj49N725s57aDXb3Lf_yyoA4ADFLPn_0_9mP2P4Fzo2nyA</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Samuels, Jason M.</creator><creator>Paddu, Nina U.</creator><creator>Rekulapeli, Akhil</creator><creator>Madhar, Ayush</creator><creator>Srivastava, Gitanjali</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>7X8</scope><orcidid>https://orcid.org/0000-0002-8326-3089</orcidid></search><sort><creationdate>2024</creationdate><title>High Prevalence of Positive Genetic Obesity Variants in Postoperative Bariatric Surgery Patients with Weight Regain Presenting for Medical Obesity Intervention</title><author>Samuels, Jason M. ; Paddu, Nina U. ; Rekulapeli, Akhil ; Madhar, Ayush ; Srivastava, Gitanjali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-6a1030a379bb48f5351d3f571c71b2183728729cbdba09c60d3d98f57457aafa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Anti-Obesity Agents - therapeutic use</topic><topic>Bariatric Surgery</topic><topic>Female</topic><topic>Gastrointestinal surgery</topic><topic>Genetics</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>Obesity</topic><topic>Obesity - epidemiology</topic><topic>Obesity - genetics</topic><topic>Obesity - surgery</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Weight control</topic><topic>Weight Gain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Samuels, Jason M.</creatorcontrib><creatorcontrib>Paddu, Nina U.</creatorcontrib><creatorcontrib>Rekulapeli, Akhil</creatorcontrib><creatorcontrib>Madhar, Ayush</creatorcontrib><creatorcontrib>Srivastava, Gitanjali</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>ProQuest 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)</collection><collection>ProQuest Central</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>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Samuels, Jason M.</au><au>Paddu, Nina U.</au><au>Rekulapeli, Akhil</au><au>Madhar, Ayush</au><au>Srivastava, Gitanjali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High Prevalence of Positive Genetic Obesity Variants in Postoperative Bariatric Surgery Patients with Weight Regain Presenting for Medical Obesity Intervention</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2024</date><risdate>2024</risdate><volume>34</volume><issue>1</issue><spage>170</spage><epage>175</epage><pages>170-175</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Introduction
Genetic obesity susceptibility in postoperative bariatric surgery weight regain (PBSWR) remains largely unexplored.
Methods
A retrospective case series of adult (
N
= 27) PBSWR patients who had undergone genetic obesity testing was conducted between Sept. 2020 and March 2022. Primary outcome: frequency of genetic variants in patients experiencing weight regain following bariatric surgery. Secondary outcomes: prevalence of obesity-related comorbidities, nadir BMI achieved post-bariatric surgery, and percent total body weight loss (%TBWL) achieved with obesity pharmacotherapies.
Results
Heterozygous mutations were identified in 22 (81%) patients, with the most prevalent mutations occurring in CEP290, RPGR1P1L, and LEPR genes (3 patients each). Median age was 56 years (interquartile range (IQR) 46.8–65.5), 88% female. Types of surgery were 67% RYGB, 19% SG, 4% gastric band, and 13% revisions. Median nadir BMI postoperatively was 34.0 kg/m
2
(IQR 29.0–38.5). A high prevalence of metabolic derangements was noted; patients presented median 80 months (IQR 39–168.5) postoperative for medical weight management with 40% weight regain. BMI at initiation of anti-obesity medication (AOMs) was 41.7 kg/m
2
(36.8–44.4). All received AOM and required at least 3 AOMs for weight regain. Semaglutide (
N
= 21), topiramate (
N
= 14), and metformin (
N
= 12) were most prescribed. Median %TBWL for the cohort at the first, second, and third visit was 1.7, 5.0, and 6.5 respectively. Fourteen (52%) achieved 5%TBWL, 10 (37%) achieved 10%TBWL, and 4 (15%) achieved 15%TBWL with combination AOMs and supervised medical intervention.
Conclusion
An unusually high prevalence of genetic obesity variants in PBSWR was found, warranting further research.
Graphical Abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37996769</pmid><doi>10.1007/s11695-023-06952-1</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-8326-3089</orcidid></addata></record> |
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| ispartof | Obesity surgery, 2024, Vol.34 (1), p.170-175 |
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| source | MEDLINE; SpringerLink |
| subjects | Adult Anti-Obesity Agents - therapeutic use Bariatric Surgery Female Gastrointestinal surgery Genetics Humans Male Medicine Medicine & Public Health Middle Aged Mutation Obesity Obesity - epidemiology Obesity - genetics Obesity - surgery Obesity, Morbid - surgery Original Contributions Prevalence Retrospective Studies Surgery Surgical outcomes Treatment Outcome Weight control Weight Gain |
| title | High Prevalence of Positive Genetic Obesity Variants in Postoperative Bariatric Surgery Patients with Weight Regain Presenting for Medical Obesity Intervention |
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