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腹腔镜袖状胃切除术 1 年后 2 型糖尿病患者体重指数的术前预测:横断面研究。

Preoperative Prediction of Body Mass Index of Patients with Type 2 Diabetes at 1 Year After Laparoscopic Sleeve Gastrectomy: Cross-Sectional Study.

机构信息

Department of Surgery, Hamad Medical Corporation, Doha, Qatar.

College of Medicine, Qatar University, Doha, Qatar.

出版信息

Metab Syndr Relat Disord. 2022 Aug;20(6):360-366. doi: 10.1089/met.2021.0153. Epub 2022 May 3.

Abstract

Very few models predict weight loss among type 2 diabetes mellitus (T2D) patients after laparoscopic sleeve gastrectomy (LSG). This retrospective study undertook such a task. We identified all patients >18 years old with T2D who underwent primary LSG at our institution and had complete data. The training set comprised 107 patients operated upon during the period April 2011 to June 2014; the validation set comprised 134 patients operated upon during the successive chronological period, July 2014 to December 2015. Sex, age, presurgery BMI, T2D duration, number of T2D medications, insulin use, hypertension, and dyslipidemia were utilized as independent predictors of 1-year BMI. We employed regression analysis, and assessed the goodness of fit and "Residuals versus Fits" plot. Paired sample -tests compared the observed and predicted BMI at 1 year. The model comprised preoperative BMI ( = 0.757,  = 0.026) + age ( = 0.142,  < 0.0001) with adjusted of 0.581 ( < 0.0001), and goodness of fit showed an unbiased model with accurate prediction. The equation was: BMI value 1 year after LSG = 1.777 + 0.614 × presurgery BMI (kg/m) +0.106 × age (years). For validation, the equation exhibited an adjusted 0.550 ( < 0.0001), and the goodness of fit indicated an unbiased model. The BMI predicted by the model fell within -3.78 BMI points to +2.42 points of the observed 1-year BMI. Pairwise difference between the mean 1-year observed and predicted BMI was not significant (-0.41 kg/m,  = 0.225). This predictive model estimates the BMI 1 year after LSG. The model comprises preoperative BMI and age. It allows the forecast of patients' BMI after surgery, hence setting realistic expectations which are critical for patient satisfaction after bariatric surgery. An attainable target motivates the patient to achieve it.

摘要

很少有模型可以预测 2 型糖尿病(T2D)患者在接受腹腔镜袖状胃切除术(LSG)后的体重减轻情况。本回顾性研究旨在解决这一问题。我们确定了在我院接受初次 LSG 治疗且资料完整的年龄大于 18 岁的 T2D 患者。训练集包括 2011 年 4 月至 2014 年 6 月期间接受手术的 107 例患者;验证集包括 2014 年 7 月至 2015 年 12 月期间接受手术的 134 例患者。性别、年龄、术前 BMI、T2D 病程、T2D 药物种类、胰岛素使用、高血压和血脂异常被用作预测术后 1 年 BMI 的独立预测因子。我们采用回归分析,并评估拟合优度和“残差与拟合值”图。配对样本 t 检验比较了 1 年时的观察值和预测值 BMI。该模型包含术前 BMI( = 0.757,  = 0.026)+年龄( = 0.142,  < 0.0001),调整后的 为 0.581( < 0.0001),拟合优度表明该模型为无偏模型,预测值准确。方程为:LSG 术后 1 年 BMI 值 = 1.777 + 0.614 × 术前 BMI(kg/m)+0.106 × 年龄(岁)。验证集的方程显示调整后的 为 0.550( < 0.0001),拟合优度表明该模型为无偏模型。模型预测的 BMI 值与观察到的 1 年 BMI 值相差在-3.78 BMI 点至+2.42 BMI 点之间。观察到的 1 年平均 BMI 值与预测 BMI 值之间的差异无统计学意义(-0.41 kg/m,  = 0.225)。该预测模型可估计 LSG 术后 1 年的 BMI。该模型包含术前 BMI 和年龄。它可以预测患者术后 BMI,从而为患者设定现实的期望,这对患者在减重手术后的满意度至关重要。一个可实现的目标可以激励患者去实现它。

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