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减重手术后体重减轻不足及其预测因素:德黑兰肥胖治疗研究(TOTS)。

Insufficient weight loss after bariatric surgery and its predictors: Tehran Obesity Treatment Study (TOTS).

作者信息

Almasi Minoo Heidari, Barzin Maryam, Mahdavi Maryam, Khalaj Alireza, Ebrahimi Danial, Valizadeh Majid, Hosseinpanah Farhad

机构信息

Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Surgery, Faculty of Medicine, Tehran Obesity Treatment Center, Shahed University, Tehran, Iran.

出版信息

Langenbecks Arch Surg. 2025 Apr 2;410(1):114. doi: 10.1007/s00423-025-03682-z.

Abstract

BACKGROUND

This study aimed to determine the factors related to insufficient weight loss (IWL) following bariatric surgery.

METHODS

The data for 3456 individuals who had bariatric surgery were obtained prospectively. A bioelectrical impedance analyzer was used to measure body composition changes and compare them between the sufficient (SWL) and IWL groups. The generalized estimated equation approach was used to assess changes in fat mass (FM), fat-free mass (FFM), FFM loss/weight loss percentage (FFML/WL%), and excess weight loss percentage (EWL%). Multivariate logistic regression models were used for IWL to establish independent baseline factors.

RESULTS

IWL was recorded in 8% of the cases. The data analysis revealed substantial differences in the changes in FM%, FFM%, FFML/WL%, and EWL% between the SWL and IWL groups after six months of follow-up. The IWL group demonstrated a greater FFML/WL% (Ptime before & after 6 months < 0.05). An older age, a higher baseline BMI, diabetes mellitus (DM), non-smoking, and sleeve gastrectomy (SG) were the predictors of IWL.

CONCLUSION

the significant predictors of IWL included older age, a higher baseline BMI, DM, SG, and non-smoking.

摘要

背景

本研究旨在确定与减肥手术后体重减轻不足(IWL)相关的因素。

方法

前瞻性获取3456例接受减肥手术患者的数据。使用生物电阻抗分析仪测量身体成分变化,并在体重充分减轻(SWL)组和IWL组之间进行比较。采用广义估计方程法评估脂肪量(FM)、去脂体重(FFM)、FFM减少量/体重减轻百分比(FFML/WL%)和超重减轻百分比(EWL%)的变化。使用多变量逻辑回归模型确定IWL的独立基线因素。

结果

8%的病例出现IWL。数据分析显示,随访6个月后,SWL组和IWL组在FM%、FFM%、FFML/WL%和EWL%的变化方面存在显著差异。IWL组的FFML/WL%更高(6个月前后时间P<0.05)。年龄较大、基线BMI较高、糖尿病(DM)、不吸烟和袖状胃切除术(SG)是IWL的预测因素。

结论

IWL的显著预测因素包括年龄较大、基线BMI较高、DM、SG和不吸烟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34b3/11965242/97da05427c9b/423_2025_3682_Fig1_HTML.jpg

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