Zhao Kang, Shi Wenbing, Xu Xinyi, Yang Ningli, Liang Hui, Xu Qin
School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu, China.
Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China.
Lipids Health Dis. 2025 May 6;24(1):165. doi: 10.1186/s12944-025-02583-w.
To investigate the body roundness index (BRI) trajectory categories 12 months post-bariatric surgery and to explore the association between BRI and metabolic abnormalities.
Subject data were pooled from a tertiary hospital at baseline, 3 and 12 months post-surgery. Anthropometric measurements included the BRI and body mass index (BMI). Metabolic biomarkers comprised triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucose (GLU), and uric acid (UA). The BRI level was categorized using growth mixture model, and a multilevel logistic regression model was employed to explore the relationship between BRI and metabolic risk.
A total of 669 patients were included in this study, comprising 286 males (42.8%) and 383 females (57.2%), with an average age of 31.70 ± 9.53 years (range of 18 to 65 years). Patients were classified into three BRI trajectory categories. Compared to the Low-gradual decline group, the High-rapid decline group had an increased risk of abnormal HDL-C (OR = 2.84 [95% CI, 1.73 ~ 4.67]), and had the highest proportion of sleeve gastrectomy plus jejunojejunal bypass (SG + JJB) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) (P < 0.001); while the High-gradual decline group had increased risk of abnormal TG (OR = 3.28 [95%CI,1.67-6.42]), HDL-C (OR = 4.30 [95%CI, 2.31 ~ 8.00]), LDL-C (OR = 2.10 [95%CI, 1.12 ~ 3.93]), and UA (OR = 2.33 [95%CI, 1.33 ~ 4.10]). After adjusting for demographics, lifestyle factors, and surgical procedures, the distribution of risk outcomes remained primarily consistent.
Sleeve gastrectomy (SG) plus procedures could potentially be associated with improvements in abdominal obesity and metabolic status in patients with high BRI. The post-bariatric trajectories based on BRI may offer insights into the metabolic risk levels of Chinese bariatric patients, but further research is needed to confirm these findings.
研究减重手术后12个月的身体圆润度指数（BRI）轨迹类别，并探讨BRI与代谢异常之间的关联。
收集一家三级医院在基线、术后3个月和12个月时的受试者数据。人体测量指标包括BRI和体重指数（BMI）。代谢生物标志物包括甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血糖（GLU）和尿酸（UA）。使用生长混合模型对BRI水平进行分类，并采用多水平逻辑回归模型探讨BRI与代谢风险之间的关系。
本研究共纳入669例患者，其中男性286例（42.8%），女性383例（57.2%），平均年龄31.70±9.53岁（年龄范围18至65岁）。患者被分为三个BRI轨迹类别。与低逐渐下降组相比，高快速下降组HDL-C异常风险增加（OR = 2.84 [95% CI，1.73 ~ 4.67]），且袖状胃切除术加空肠空肠旁路术（SG + JJB）和单吻合十二指肠空肠旁路术联合袖状胃切除术（SADI-S）的比例最高（P < 0.001）；而高逐渐下降组TG异常（OR = 3.28 [95%CI，1.67 - 6.42]）、HDL-C异常（OR = 4.30 [95%CI，2.31 ~ 8.00]）、LDL-C异常（OR = 2.10 [95%CI，1.12 ~ 3.93]）和UA异常（OR = 2.33 [95%CI，1.33 ~ 4.10]）的风险增加。在调整人口统计学、生活方式因素和手术方式后，风险结局的分布基本保持一致。
袖状胃切除术（SG）加其他手术可能与高BRI患者腹部肥胖和代谢状况的改善有关。基于BRI的减重术后轨迹可能有助于了解中国减重患者的代谢风险水平，但需要进一步研究来证实这些发现。
