Early Weight Loss Following Laparoscopic Sleeve Gastrectomy Is Predictive of Long-Term Weight Loss in Morbidly Obese Chi
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ORIGINAL CONTRIBUTIONS
Early Weight Loss Following Laparoscopic Sleeve Gastrectomy Is Predictive of Long-Term Weight Loss in Morbidly Obese Chinese Liang Wang 1 & Qing Sang 1 & Xuejing Zheng 1 & Dexiao Du 1 & Nengwei Zhang 1
&
Dongbo Lian 1,2
Received: 22 July 2020 / Revised: 30 September 2020 / Accepted: 6 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Laparoscopic sleeve gastrectomy (LSG) is a bariatric surgical approach often used to treat Chinese individuals suffering from morbid obesity. Objectives To verify the long-term safety and efficiency of LSG and to evaluate the predictive effect of initial weight loss on long-term weight maintenance after LSG in morbidly obese Chinese. Methods Follow-up was conducted by telephone or in hospital. We measured the body mass index (BMI), percentage of total body weight loss (%TWL), and excess weight loss (%EWL), and assessed patients for the alleviation of co-morbidities. Relationships between initial weight loss and successful weight maintenance were assessed via linear regression analyses, while optimal cutoff values were determined based on receiver operative characteristic (ROC) curves. Results We included 384 patients in this study. Before surgery, these patients had median weight and BMI values of 110 (91.00– 130.75) kg and 38.49 (32.82–44.12) kg/m2, respectively. Successful weight loss of > 50% EWL was accomplished in 91.21%, 82.69%, and 79.37% of patients at 1, 3, and 5 years after surgery. In addition, the %EWL at 6 months was significantly correlated with the %EWL up to 5 years (P < 0.001) in morbidly obese Chinese. Based on the ROC curve, the EWL of 56.54% at 6 months was the best predictor of successful weight loss at 5 years (sensitivity 72.38%, specificity 82.69%) in morbidly obese Chinese. Conclusion LSG has long-term safety and efficacy for morbidly obese Chinese patients. The %EWL at 6 months can be used to predict weight maintenance up to 5 years after LSG. Keywords Laparoscopic sleeve gastrectomy . Remission of obesity-related co-morbidities . Early weight loss . Long-term weight maintenance
Introduction * Nengwei Zhang [email protected] * Dongbo Lian [email protected] Liang Wang [email protected] Qing Sang [email protected] Xuejing Zheng [email protected] Dexiao Du [email protected] 1
Surgery Centre of Diabetes Mellitus, Peking University Ninth School of Clinical Medicine, Beijing 100038, China
2
Shijitan Hospital, Tieyi Road, Haidian District, Beijing, China
Global obesity rates have doubled in the past 50 years such that roughly one-third of the global populace is now either obese or overweight [1]. Obesity impairs a multitude of biological processes and thus represents a major threat to public health, causing a huge burden on the state’s finances [2–5]. Bariatric surgery is both reliable and effective in treating individuals who are morbidly obese, and as such, it has been increasingly used to combat obesity [6]. Laparoscopic sleeve gastrectomy (LSG) is among the most widely used b
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