title: Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery.
abstract: BACKGROUND
  Bariatric surgery (BS) is widely accepted for the treatment of patients with morbid obesity (MO). We aimed to determine presurgical predictors of and surgical technique-related differences in excess weight loss (EWL) 1 year after BS.
  
  
  METHODS
  This retrospective study included 407 subjects (F/M 3:1, median age = 44 years) who underwent laparoscopic Roux-en-Y gastric bypass (RYGB, n = 307) or sleeve gastrectomy (SG, n = 100) at our University Hospital and were evaluated 1 year after surgery.
  
  
  RESULTS
  Baseline median (min-max) body mass index (BMI) was 47 kg/m(2) (range = 36-71). BMI was higher in the SG than in the RYGB group (53 vs. 46 kg/m(2), p < 0.0001). Simple correlation analysis showed negative associations between EWL and age, BMI, waist circumference (WC), fasting glucose, HbA1c, triglycerides (TG), blood pressure, and total cholesterol (all p < 0.01). EWL (mean ± SD) did not differ by gender (p = 0.2), was lower in diabetic than in nondiabetic subjects (71 ± 17% vs. 79 ± 17%, p < 0.0001), and higher in the RYGB vs. SG group (76 ± 18% vs. 68 ± 15%, p < 0.0001). However, SG vs. RYGB differences in EWL disappeared (p = 0.4) after taking into account baseline BMI. Multiple regression and logistic analysis showed that younger individuals with lower BMI but higher WC, and lower HbA1c and TG, had higher EWL and a higher rate of successful (EWL ≥ 60%) weight loss.
  
  
  CONCLUSIONS
  Our data indicate that some of the characteristics that would have subjects referred early for BS were associated with higher weight loss. Therefore, the timing of laparoscopic BS might be an important factor for MO individuals in which medical weight loss intervention has failed.
authors.affiliation: Obesity Unit, Department of Diabetes and Endocrinology, IDIBAPS, ICMDM, Hospital Clínic i Universitari, C/Villarroel 170, 08036 Barcelona, Spain. eortega1@clinic.ub.es
authors.forename: Emilio
authors.initials: E
authors.lastname: Ortega
authors.forename: Rosa
authors.initials: R
authors.lastname: Morínigo
authors.forename: Lilliam
authors.initials: L
authors.lastname: Flores
authors.forename: Violeta
authors.initials: V
authors.lastname: Moize
authors.forename: Martin
authors.initials: M
authors.lastname: Rios
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Lacy
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D048909:Diabetes Complications / Q000097:blood; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000601:surgery*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin