Giovanino Accetta Victor, da Silva Alessandra, Lopes Pinto Sônia
Postgraduate Program in Health Sciences, Federal University of Tocantins, Palmas, Brazil.
Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Obes Surg. 2025 Jun 21. doi: 10.1007/s11695-025-08010-4.
Bariatric surgery is effective in treating severe obesity, but weight recurrence (WR) after the procedure is a growing concern. The lack of consensus on cutoff points to define WR and its association with comorbidities is still a gap in the literature.
To evaluate the prevalence of WR obtained through different cutoff points in patients who underwent bariatric surgery and its association with cardiometabolic risk markers.
A cross-sectional observational study was carried out with patients who underwent bariatric surgery more than two years ago through the public health system from 2011 to 2019. Data collection was performed in person and remotely, with an assessment of anthropometric and metabolic variables. WR was analyzed in different percentages (15%, 25%, 35%, 45%) and associated with metabolic and biochemical variables.
Ninety-five individuals participated in this study; 84.2% were women aged 43 years (range 22 to 66 years). Individuals with WR ≥ 15% had significantly higher insulin and HOMA-IR values vs. WR < 15%, while those with WR ≥ 25% also had reduced ferritin levels and higher TyG index values vs. WR < 25%. For the first time, it was observed that subjects with WR ≥ 35% had higher triglyceride levels vs. WR < 35%. No significant difference in metabolic variables was observed when WR ≥ 35% was compared with WR ≥ 45%.
WR ≥ 15% was associated with some cardiometabolic risk markers, and these remain as WR increases.
减重手术在治疗重度肥胖方面有效，但术后体重复发（WR）问题日益受到关注。目前对于定义WR的切点以及WR与合并症之间的关联缺乏共识，这仍是文献中的一个空白。
评估接受减重手术患者通过不同切点得出的WR患病率及其与心脏代谢风险标志物的关联。
对2011年至2019年通过公共卫生系统接受减重手术超过两年的患者进行了一项横断面观察性研究。通过面对面和远程方式收集数据，评估人体测量和代谢变量。对不同百分比（15%、25%、35%、45%）的WR进行分析，并与代谢和生化变量相关联。
95名个体参与了本研究；84.2%为43岁（范围22至66岁）的女性。WR≥15%的个体与WR<15%的个体相比，胰岛素和HOMA-IR值显著更高，而WR≥25%的个体与WR<25%的个体相比，铁蛋白水平降低且TyG指数值更高。首次观察到WR≥35%的受试者与WR<35%的受试者相比，甘油三酯水平更高。将WR≥35%与WR≥45%进行比较时，未观察到代谢变量有显著差异。
WR≥15%与一些心脏代谢风险标志物相关，且随着WR增加这些标志物依然存在。
