Department of General and Visceral Surgery, Medical Center Freiburg, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
Department of Epigenetics, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI, 49503, USA.
Obes Surg. 2023 May;33(5):1519-1527. doi: 10.1007/s11695-023-06499-1. Epub 2023 Mar 1.
Parental predisposition and age of onset may be independently associated with 1-year total weight loss (TWL) failure (< 20%) after metabolic-bariatric surgery (MBS).
This cohort study includes all cases of the German StuDoQ|MBE register (2015-2019) with data on parental predisposition, obesity onset, and at least 1-year follow up after primary MBS procedures (n = 14,404). We provide descriptive statistics of the cohort in terms of the main outcome and 1-year TWL failure, and provide characteristics of surgery type subgroups. Finally, we provide a multivariate logistic regression model of 1-year TWL failure.
58.8% and 45.7% of patients reported maternal and paternal predisposition for obesity, respectively. Average onset of obesity was 15.5 years and duration of disease 28.3 years prior to MBS. SG is the most frequently performed procedure (47.2%) followed by RYGB (39.7%) and OAGB (13.1%). Mean 1-year TWL is 32.7 ± 9.3%, and 7.8% (n = 1,119) of patients show TWL failure (< 20%). Multivariate analysis shows independent association of early onset of obesity (< 18 years), male sex, age at operation, pre-operative BMI, pre-operative weight loss, sleeve gastrectomy (SG), and type 2 diabetes (T2D) with 1-year TWL failure (p < 0.001).
The proportions of MBS patients that report on paternal and maternal predisposition for obesity are 45.7% and 58.8% respectively, and average age at onset is 15.5 years. 7.8% of patients do not meet current target criteria of successful response to surgery at 1 year. Early onset, male sex, age at operation, pre-operative BMI, pre-operative weight loss, SG, and T2D are independently associated with weight loss failure.
父母易感性和发病年龄可能与代谢减重手术后（MBS）1 年总减重失败（<20%）独立相关。
本队列研究纳入了德国 StuDoQ|MBE 登记处（2015-2019 年）的所有病例，这些病例的数据包括父母易感性、肥胖发病年龄和 MBS 主要手术治疗后至少 1 年的随访（n=14404）。我们提供了主要结局和 1 年总减重失败的队列描述性统计数据，并提供了手术类型亚组的特征。最后，我们提供了 1 年总减重失败的多变量逻辑回归模型。
分别有 58.8%和 45.7%的患者报告了母亲和父亲肥胖易感性。肥胖的平均发病年龄为 15.5 岁，在 MBS 前疾病的持续时间为 28.3 年。SG 是最常进行的手术（47.2%），其次是 RYGB（39.7%）和 OAGB（13.1%）。1 年总减重平均为 32.7±9.3%，7.8%（n=1119）的患者出现减重失败（<20%）。多变量分析显示，肥胖发病年龄早（<18 岁）、男性、手术年龄、术前 BMI、术前体重减轻、袖状胃切除术（SG）和 2 型糖尿病（T2D）与 1 年总减重失败独立相关（p<0.001）。
报告父母肥胖易感性的 MBS 患者比例分别为 45.7%和 58.8%，平均发病年龄为 15.5 岁。7.8%的患者在 1 年时不符合手术成功应答的当前目标标准。发病年龄早、男性、手术年龄、术前 BMI、术前体重减轻、SG 和 T2D 与减重失败独立相关。
