Sankar Adhithya, McNeilage Caitlin, Alkhaffaf Bilal, Syed Akheel A
Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
Department of Oesophago-Gastric and Bariatric Surgery, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
Diabetes Obes Metab. 2025 Apr;27(4):2206-2213. doi: 10.1111/dom.16219. Epub 2025 Jan 30.
Estimation of post-bariatric surgery weight loss is important for informed clinical decisions, yet existing predictive models lack accuracy and reliability. We assessed the effectiveness of the validated Stratification of Obesity Phenotypes to Optimize Future Therapy (SOPHIA) bariatric weight trajectory prediction tool in our patient population.
We conducted a retrospective study of 178 adults who underwent bariatric surgery over a 3-year period. Actual weights at baseline and annually over 5 years of follow-up were compared with predicted weights to calculate mean difference and median absolute deviation (MAD).
The study comprised 157 women (88.2%) and 21 men (11.8%) with mean (standard deviation) age of 46.9 (10.6) years and baseline weight of 138.4 (23.5) kg. The bariatric surgical procedures included 148 (83.1%) gastric bypass, 19 (10.7%) sleeve gastrectomy and 11 (6.2%) gastric band operations. The proportion of patients with actual weights within the prediction interquartile range (IQR) was 50.7%, 43.2% and 38.8% at 12, 24 and 60 months, respectively. The mean difference between actual and predicted weight at 60 months was 0.6 (16.7) kg, p = 0.654 (paired t test). The mean MAD at 60 months was 12.9 (95% CI, 11.3-14.4) kg, indicating moderate predictive utility. The predictive accuracy was highest for gastric bypass. Subgroup analysis revealed greater accuracy in patients without diabetes/pre-diabetes, and in nonsmokers.
The SOPHIA study tool provides accurate postoperative weight forecasts for some subgroups of patients, but its precision diminishes with time. This study reiterates the necessity for better personalized weight prediction tools to inform bariatric surgery decision-making.
评估减重手术后的体重减轻情况对于做出明智的临床决策很重要，但现有的预测模型缺乏准确性和可靠性。我们评估了经过验证的肥胖表型分层以优化未来治疗（SOPHIA）减重体重轨迹预测工具在我们患者群体中的有效性。
我们对178名在3年期间接受减重手术的成年人进行了一项回顾性研究。将基线时以及随访5年期间每年的实际体重与预测体重进行比较，以计算平均差异和中位数绝对偏差（MAD）。
该研究包括157名女性（88.2%）和21名男性（11.8%），平均（标准差）年龄为46.9（10.6）岁，基线体重为138.4（23.5）千克。减重手术方式包括148例（83.1%）胃旁路手术、19例（10.7%）袖状胃切除术和11例（6.2%）胃束带手术。实际体重处于预测四分位间距（IQR）内的患者比例在12、24和60个月时分别为50.7%、43.2%和38.8%。60个月时实际体重与预测体重的平均差异为0.6（16.7）千克，p = 0.654（配对t检验）。60个月时的平均MAD为l2.9（95%CI，11.3 - 14.4）千克，表明具有中等预测效用。胃旁路手术的预测准确性最高。亚组分析显示，无糖尿病/糖尿病前期患者和非吸烟者的预测准确性更高。
SOPHIA研究工具为部分患者亚组提供了准确的术后体重预测，但随着时间推移其精度会降低。本研究重申了需要更好的个性化体重预测工具来为减重手术决策提供依据。
