Park Ji Yeon, Chung Yoona, Shin Jieun, Shin Ji-Yeon, Kim Yong Jin
Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea.
J Metab Bariatr Surg. 2024 Jun;13(1):8-16. doi: 10.17476/jmbs.2024.13.1.8. Epub 2024 Jun 4.
This study aimed to develop a predictive model for monitoring chronological weight loss during the early postoperative period following bariatric surgery in Korean patients with morbid obesity.
The baseline characteristics and postoperative weight loss outcomes were collected for up to 24 months after surgery in patients who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). The factors influencing weight loss outcomes were analyzed, and longitudinal percentile charts were plotted using quantile regression models adjusted for the identified independent factors.
The analysis included 491 and 274 patients who underwent SG and RYGB, respectively, of whom 225 (29.4%) were men. A positive association was found between the maximum percentage of total weight loss (%TWL) and female sex, body mass index (BMI) ≥40, and age <40 years. Among patients who reached nadir BMI or had at least 12 months of follow-up data (n=304), 7.6% exhibited inadequate weight loss (TWL <20%). The predictors of insufficient weight loss were older age (>40 years), male sex, and psychological problems. Centile charts were generated for the entire cohort, incorporating age, sex, and the type of procedure as covariates.
The percentile charts proposed in the present study can assist surgeons and healthcare providers in gauging patients' progress toward their weight loss goals and determining the timing of adjunctive intervention in poor responders during early postoperative follow-up.
本研究旨在建立一个预测模型，用于监测韩国病态肥胖患者减肥手术后早期的时间性体重减轻情况。
收集接受袖状胃切除术（SG）或 Roux-en-Y 胃旁路术（RYGB）患者术后长达 24 个月的基线特征和体重减轻结果。分析影响体重减轻结果的因素，并使用针对已确定独立因素进行调整的分位数回归模型绘制纵向百分位数图表。
分析分别纳入了 491 例接受 SG 手术和 274 例接受 RYGB 手术的患者，其中 225 例（29.4%）为男性。发现总体重减轻最大百分比（%TWL）与女性性别、体重指数（BMI）≥40 以及年龄<40 岁之间存在正相关。在达到最低点 BMI 或有至少 12 个月随访数据的患者（n = 304）中，7.6%的患者体重减轻不足（TWL<20%）。体重减轻不足的预测因素为年龄较大（>40 岁）、男性性别和心理问题。为整个队列生成了百分位数图表，将年龄、性别和手术类型作为协变量纳入其中。
本研究提出的百分位数图表可帮助外科医生和医疗服务提供者评估患者在减肥目标方面的进展，并确定术后早期随访中反应不佳者辅助干预的时机。
