Moreira Sophia Helena Camargos, Alvarez-Leite Jacqueline Isaura, Souza Renan Pedra, Resmini Giulia Carregal, Resende Cristina Maria Mendes, de Marco Luiz, Bastos-Rodrigues Luciana
Molecular Medicine Technology Center, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Brazil.
J Obes Metab Syndr. 2024 Dec 30;33(4):337-347. doi: 10.7570/jomes23067. Epub 2024 Oct 30.
Roux-en-Y gastric bypass (RYGB) is a standard treatment for severe obesity, but some patients do not achieve the expected success in weight loss. The aim of this study was to evaluate possible predictors of weight loss after RYGB.
Sixty-three patients were included. Pre- and postoperative data were collected from medical records, including comorbidities, anthropometry, energy/macronutrient intake, and physical activity level (PAL). Variants in the brain-derived neurotrophic factor () and lysophospholipase like 1 () genes were investigated. Excess weight loss (EWL) >50% was considered to be successful weight loss (SWL). Logistic regression models were used to verify predictor variables.
Participants' median preoperative body mass index (BMI) was 53 kg/m (interquartile range, 46 to 58). At 12 and 24 months after surgery, EWL was 63% and 67%, and the failure rate was 19% and 16%, respectively. The individuals with insufficient weight loss (IWL) after 12 months had higher preoperative weight, BMI, and overweight. At 24 months, lowest frequency of individuals with SWL in the first year was found in the IWL group. No significant differences were found between the groups in dietary intake and PAL. In the logistic regression, high initial BMI was a predictor of the worst response in both periods, and high initial total weight loss was a predictor of a better response at 24 months. The polymorphism analysis did not show differences between groups in either gene.
Lower preoperative BMI and greater weight loss at 12 months were predictors of SWL after RYGB.
Roux-en-Y胃旁路术（RYGB）是重度肥胖的标准治疗方法，但一些患者并未达到预期的减肥效果。本研究的目的是评估RYGB术后体重减轻的可能预测因素。
纳入63例患者。从病历中收集术前和术后数据，包括合并症、人体测量学、能量/宏量营养素摄入和身体活动水平（PAL）。研究了脑源性神经营养因子（BDNF）和溶血磷脂酶样1（LYPLAL1）基因的变异。超重减轻（EWL）>50%被认为是成功减肥（SWL）。使用逻辑回归模型验证预测变量。
参与者术前体重指数（BMI）中位数为53kg/m²（四分位间距，46至58）。术后12个月和24个月时，EWL分别为63%和67%，失败率分别为19%和16%。术后12个月体重减轻不足（IWL）的个体术前体重、BMI和超重情况更高。在24个月时，IWL组中第一年达到SWL的个体频率最低。两组在饮食摄入和PAL方面未发现显著差异。在逻辑回归中，高初始BMI是两个时期反应最差的预测因素，高初始总体重减轻是24个月时反应较好的预测因素。多态性分析未显示两组在任何一个基因上存在差异。
较低的术前BMI和术后12个月更大的体重减轻是RYGB术后SWL的预测因素。
