Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Department of Pathology, Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing, China.
Ann Nutr Metab. 2021;77(3):168-177. doi: 10.1159/000516522. Epub 2021 Aug 2.
BACKGROUND/AIMS: Roux-en-Y gastric bypass (RYGB) is one of the most effective therapies for morbid obesity, yet some patients who have taken the surgery still undergo insufficient weight loss. Visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), and cardiometabolic index (CMI) have been regarded as clinical indicators of adiposity phenotypes that associated closely with obesity-related metabolic diseases. However, no studies have evaluated the relationship between these indexes and weight loss after bariatric surgery. In this prospective study, we aimed to evaluate whether VAI, LAP, BAI, and CMI would predict postoperative weight loss outcomes after RYGB.
This study included 38 men and 67 women who have undergone RYGB between January 2017 and May 2018 and recorded their %TWL (percent of total weight loss), %EBMIL (percent of excess body mass index loss), %EWL (percent of excess weight loss), anthropometric indices, and biochemical parameters before and 12 months after the surgery. In addition, VAI, LAP, BAI, and CMI were measured with anthropometric measures or lipid profiles using related equations and analyzed with metabolic characteristics.
Subjects with lower BAI (<32.54 in men and 37.39 in women) displayed higher %EBMIL and %EWL 12 months after surgery. BAI was independently associated with %EWL 12 months after surgery in both men and women (both p < 0.05). The area under the receiver operating characteristic curve for BAI was significantly higher (0.773 in men and 0.818 in women) than VAI, LAP, and CMI.
BAI serves as a reliable surrogate marker of the weight loss outcome after RYGB. The predictivity of adiposity indexes in beneficial outcomes after weight loss therapies is of important referential value for the implementation and optimization of individualized and refined weight loss treatments for obese patients.
背景/目的:Roux-en-Y 胃旁路术(RYGB)是治疗病态肥胖最有效的疗法之一,但有些接受过手术的患者仍未达到足够的减重效果。内脏脂肪指数(VAI)、脂积产物(LAP)、体脂指数(BAI)和心脏代谢指数(CMI)已被视为与肥胖相关代谢疾病密切相关的肥胖表型的临床指标。然而,目前还没有研究评估这些指标与减肥手术后体重减轻之间的关系。在这项前瞻性研究中,我们旨在评估 VAI、LAP、BAI 和 CMI 是否可以预测 RYGB 术后体重减轻的结果。
本研究纳入了 2017 年 1 月至 2018 年 5 月间接受 RYGB 的 38 名男性和 67 名女性患者,记录了他们手术前和手术后 12 个月的%TWL(总体重减轻百分比)、%EBMIL(多余体重指数损失百分比)、%EWL(多余体重损失百分比)、人体测量学指标和生化参数。此外,还使用相关方程根据人体测量学测量值或血脂谱测量 VAI、LAP、BAI 和 CMI,并分析其与代谢特征的关系。
BAI 值较低(男性<32.54,女性<37.39)的患者术后 12 个月时的%EBMIL 和%EWL 更高。BAI 与男女患者术后 12 个月时的%EWL 独立相关(均 p<0.05)。BAI 对男性和女性术后 12 个月时的 ROC 曲线下面积均显著高于 VAI、LAP 和 CMI(分别为 0.773 和 0.818)。
BAI 是 RYGB 术后体重减轻结果的可靠替代指标。在减重治疗有益结果中,脂肪指数的预测性对于肥胖患者个体化和精细化减重治疗的实施和优化具有重要的参考价值。