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Obesity Surgery
Published in: Obesity Surgery 11/2015

01-11-2015 | Original Contributions

Preoperative Predictive Factors of Successful Weight Loss and Glycaemic Control 1 Year After Gastric Bypass for Morbid Obesity

Authors: Silvia Palmisano, Marta Silvestri, Michela Giuricin, Edoardo Baldini, Simone Albertario, Patrizio Capelli, Bernardo Marzano, Giovanni Fanti, Aron Zompicchiatti, Paolo Millo, Massimiliano Fabozzi, Riccardo Brachet Contul, Elisa Ponte, Rosaldo Allieta, Nicolò de Manzini

Published in: Obesity Surgery | Issue 11/2015

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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/m2 (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/m2 (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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Metadata
Title
Preoperative Predictive Factors of Successful Weight Loss and Glycaemic Control 1 Year After Gastric Bypass for Morbid Obesity
Authors
Silvia Palmisano
Marta Silvestri
Michela Giuricin
Edoardo Baldini
Simone Albertario
Patrizio Capelli
Bernardo Marzano
Giovanni Fanti
Aron Zompicchiatti
Paolo Millo
Massimiliano Fabozzi
Riccardo Brachet Contul
Elisa Ponte
Rosaldo Allieta
Nicolò de Manzini
Publication date
01-11-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 11/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1662-2

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