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Obesity Surgery

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01-12-2020 | Bariatric Surgery | Original Contributions

Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study

Authors: Hassan Aliakbarian, Hina Y. Bhutta, Keyvan Heshmati, Shebna Unes Kunju, Eric G. Sheu, Ali Tavakkoli

Published in: Obesity Surgery | Issue 12/2020

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/m² 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.

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Title: Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study
Authors: Hassan Aliakbarian
Hina Y. Bhutta
Keyvan Heshmati
Shebna Unes Kunju
Eric G. Sheu
Ali Tavakkoli
Publication date: 01-12-2020
Publisher: Springer US
Keywords: Bariatric Surgery
Bariatric Surgery
Type 2 Diabetes
Published in: Obesity Surgery / Issue 12/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-020-04877-7

At a glance: The STEP trials

Springer Medicine

Pre-operative Predictors of Weight Loss and Weight Regain Following Roux-en-Y Gastric Bypass Surgery: a Prospective Human Study

Abstract

Background

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusions

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