Fasting glycemia: A good predictor of weight loss after RYGB

• Type: Article in International Scientific Journal
• Date: 2014

Authors

Faria, Gil (Author) ICBAS; John Preto (Author) FMUP; Almeida, AB (Author) Other; guimaraes, jt (Author) FMUP; Conceicao Calhau (Author) FMUP; Gomes AT (Author) FMUP

Journal

Title: Surgery for Obesity and Related Diseases

Vol. 10

Pages: 419-424

ISSN: 1550-7289

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 24 Citations

Scopus - 24 Citations

Other information

Authenticus ID: P-009-M2J

DOI: 10.1016/j.soard.2013.11.005

Abstract (EN): Background: Preoperative prediction of weight loss after Roux-en-Y gastric bypass (RYGB) could help surgeons in managing surgical lists and patients' expectations. The objective of this study was to understand if preoperative metabolic control might improve surgical results. Methods: Prospective cohort of 163 consecutive patients who underwent RYGB with at least 1 year of follow-up. Results: Most patients were female (90.2%), with a mean age of 38 (19-60) and a BMI of 46.0 (34.3-59.9) kg/m(2). After 12 months, the mean body mass index (BMI) was 29.7 kg/m(2) (21.5-39.9) with a corresponding percentage of excess weight lost (%EWL) of 78.8% and a percentage of weight loss (%WL) of 35.1%. Patients with the highest preoperative fasting blood glucose (FBG) were older (42 versus 36; P < .001); were more likely to have type 2 diabetes (T2 DM, 40% versus 6.8%; P < .001) and metabolic syndrome (89% versus 25%; P < .001), had a slightly higher BMI (30.8 versus 29.3 kg/m(2); P = .03), and had achieved a significantly lower %EWL and %WL at 12 months (72.5% versus 81.2%; P = .004; 33.2 versus 35.9%; P = .03, respectively). We observed a dose-response effect with increasing FBG (< 85 mg/dL, 85-100 mg/dL, and >= 100 mg/dL, respectively), with 83.5%, 80.0%, and 72.5% (P = .009) of %EWL at 12 months. By multivariate logistic regression, initial BMI and FBG > 100, were the only variables related (inversely) with the probability of achieving a %EWL > 80 or %WL > 35. This effect was not detected in patients receiving oral antidiabetic medications. Conclusion: Higher preoperative FBG is independently related to a poorer weight loss 12 months after RYGB; this suggests the need to offer earlier surgical intervention for severely obese patients with impairment of glucose metabolism. The potential for less weight loss in patients with a higher FBG should not discourage RYGB, given the significant metabolic improvement after surgery.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6