Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
Center for Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, Japan.
Surg Obes Relat Dis. 2020 Dec;16(12):1978-1987. doi: 10.1016/j.soard.2020.07.033. Epub 2020 Aug 11.
Obesity is a leading cause of metabolic disorders and mortality. Laparoscopic sleeve gastrectomy (LSG) confers beneficial effects not only on weight but also on metabolic disorder development. However, some patients show insufficient weight loss after LSG. A total weight loss percentage (%TWL) <20% after LSG is defined as insufficient. The prediction of patients with insufficient weight loss after LSG before the procedure is performed may prove helpful.
To determine predictors of %TWL after LSG.
Longitudinal study in a university hospital.
We retrospectively reviewed 90 obese patients who underwent LSG and were followed up for 12 months thereafter. We analyzed the relationship between %TWL and preoperative clinical parameters, such as age, sex, body mass index, lipid and glucose metabolism, and some hormones. Patients were divided into 2 groups, %TWL <20% and 20% ≤ %TWL. Multiple regression model and logistic regression models were performed.
LSG led to significant improvements in weight, liver, and kidney function, and lipid and glucose metabolism. The serum insulin-like growth factor-1 (IGF-1) level was significantly lower in patients with %TWL <20%. Sex, diabetes presence, body mass index, and IGF-1 were independent predictors of %TWL. Receiver operating characteristic curve analysis showed that the cutoff value of IGF-1 for %TWL <20% was 100.0ng/mL. Male sex, diabetes presence, lower preoperative BMI, and IGF-1 values were independently associated with lower %TWL (%TWL <20%).
Serum IGF-1 can be used to screen for patients at risk of low %TWL after LSG.
肥胖是代谢紊乱和死亡的主要原因。腹腔镜袖状胃切除术（LSG）不仅对体重，而且对代谢紊乱的发展都有有益的影响。然而，一些患者在 LSG 后体重减轻不足。LSG 后总减重百分比（%TWL）<20%定义为不足。在进行手术前预测 LSG 后体重减轻不足的患者可能会有所帮助。
确定 LSG 后%TWL 的预测因素。
在一所大学医院进行的纵向研究。
我们回顾性分析了 90 例肥胖患者，这些患者接受了 LSG 手术，并在术后 12 个月进行了随访。我们分析了%TWL 与术前临床参数（如年龄、性别、体重指数、血脂和血糖代谢以及某些激素）之间的关系。患者被分为 2 组，%TWL<20%和 20%≤%TWL。进行了多元回归模型和逻辑回归模型分析。
LSG 导致体重、肝功能和肾功能以及血脂和血糖代谢显著改善。%TWL<20%的患者血清胰岛素样生长因子-1（IGF-1）水平显著降低。性别、糖尿病存在、体重指数和 IGF-1 是%TWL 的独立预测因素。受试者工作特征曲线分析显示，IGF-1 对%TWL<20%的截断值为 100.0ng/mL。男性、糖尿病存在、术前 BMI 较低和 IGF-1 值较低与较低的%TWL（%TWL<20%）独立相关。
血清 IGF-1 可用于筛选 LSG 后低%TWL 风险的患者。
