Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing, 100038, China.
Shijitan Hospital, Tieyi Road, Haidian District, Beijing, China.
Obes Surg. 2021 Apr;31(4):1647-1655. doi: 10.1007/s11695-020-05173-0. Epub 2021 Jan 3.
This study assessed the efficacy and safety of laparoscopic sleeve gastrectomy (LSG) in Chinese individuals with a body mass index (BMI) under 35 kg/m and to explore the association between early weight loss and sustained weight maintenance.
Patients whose BMI < 35 kg/m were recruited. Changes in BMI, total weight loss (%TWL), and excess weight loss (%EWL) were evaluated, with successful weight loss being a %EWL of > 50% and a %TWL of > 25%. Binary logistic regression was employed to assess relationships between %EWL and %TWL and to calculate a joint predictor. The association between early weight loss and sustained weight maintenance was assessed as a function of %EWL, %TWL, and this joint predictor, with receiver operating characteristic (ROC) curves being used for optimal cutoff threshold identification.
In total, 143 individuals with average preoperative weight and BMI values of 88 (82, 95) kg and 31.99 (29.41, 33.15) kg/m, respectively, were enrolled in present study. At 5 years, 48.00% of patients achieved successful weight loss. Both 3-month %EWL and %TWL were significantly related to sustained weight loss at 5 years (P < 0.05). ROC curves were used to identify %TWL of 19.54% at 3 months as the most reliable predictor of weight loss at a 5-year follow-up (sensitivity: 61.11%, specificity: 76.92%).
LSG had long-term safety and efficacy, and %TWL at 3 months can predict sustained 5-year weight loss in Chinese individuals with BMI < 35 kg/m.
本研究评估了腹腔镜袖状胃切除术（LSG）在 BMI 低于 35kg/m 的中国人群中的疗效和安全性，并探讨了早期体重减轻与持续体重维持之间的关系。
招募 BMI<35kg/m 的患者。评估 BMI、总减重（%TWL）和多余体重减轻（%EWL）的变化，成功的减重定义为%EWL>50%和%TWL>25%。采用二元逻辑回归评估%EWL 和%TWL 之间的关系，并计算联合预测因子。通过%EWL、%TWL 和该联合预测因子评估早期体重减轻与持续体重维持之间的关系，并使用接收者操作特征（ROC）曲线确定最佳截断阈值。
本研究共纳入 143 例平均术前体重和 BMI 值分别为 88（82，95）kg 和 31.99（29.41，33.15）kg/m 的患者。5 年后，48.00%的患者达到了成功的减重。3 个月时的%EWL 和%TWL 与 5 年时的持续减重显著相关（P<0.05）。ROC 曲线用于确定 3 个月时的%TWL 为 19.54%，作为 5 年随访时体重减轻的最可靠预测因子（敏感性：61.11%，特异性：76.92%）。
LSG 具有长期的安全性和疗效，3 个月时的%TWL 可预测 BMI<35kg/m 的中国人群持续 5 年的体重减轻。
