title: Preoperative Predictive Factors of Successful Weight Loss and Glycaemic Control 1 Year After Gastric Bypass for Morbid Obesity.
abstract: BACKGROUND
  Gastric bypass (GBP) is one of the most effective surgical procedures to treat morbid obesity and the related comorbidities. This study aimed at identifying preoperative predictors of successful weight loss and type 2 diabetes mellitus (T2DM) remission 1 year after GBP.
  
  
  METHODS
  Prospective longitudinal study of 771 patients who underwent GBP was performed at four Italian centres between November 2011 and May 2013 with 1-year follow-up. Preoperative anthropometric, metabolic and social parameters, the surgical technique and the previous failed bariatric procedures were analyzed. Weight, the body mass index (BMI), the percentage of excess weight lost (% EWL), the percentage of excess BMI lost (% BMIL) and glycated haemoglobin (HbA1c) were recorded at follow-up.
  
  
  RESULTS
  Univariate and multivariate analysis showed that BMI <50 kg/m(2) (p = 0.006) and dyslipidaemia (p = 0.05) were predictive factors of successful weight loss. Multivariate analysis of surgical technique showed significant weight loss in patients with a small gastric pouch (p < 0.001); the lengths of alimentary and biliary loops showed no statistical significance. All diabetic patients had a significant reduction of HbA1c (p < 0.001) after surgery. BMI ≥ 50 kg/m(2) (p = 0.02) and low level of preoperative HbA1c (p < 0.01) were independent risk factors of T2DM remission after surgery.
  
  
  CONCLUSIONS
  This study provides a useful tool for making more accurate predictions of best results in terms of weight loss and metabolic improvement.
authors.affiliation: Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. spalmisano@units.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Palmisano
authors.affiliation: Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. silvestri_marta@libero.it.
authors.forename: Marta
authors.initials: M
authors.lastname: Silvestri
authors.affiliation: Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. michelagiuricin@libero.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Giuricin
authors.affiliation: Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy. e.baldini@ausl.pc.it.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Baldini
authors.affiliation: Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy. s.albertario@ausl.pc.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Albertario
authors.affiliation: Unità Operativa di Chirurgia Generale, Toracica e Vascolare, Ospedale "Guglielmo da Saliceto", via Taverna 49, 29122, Piacenza, Italy. p.capelli@ausl.pc.it.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Capelli
authors.affiliation: Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy. bernardo.marzano@gmail.com.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Marzano
authors.affiliation: Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy. giovanni.fantipn@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fanti
authors.affiliation: Department of Surgery, Santa Maria degli Angeli Hospital, Via Montereale 24, 33170, Pordenone, Italy. aronillo@yahoo.it.
authors.forename: Aron
authors.initials: A
authors.lastname: Zompicchiatti
authors.affiliation: Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. pmillo@ausl.vda.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Millo
authors.affiliation: Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. mfabozzi@ausl.vda.it.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fabozzi
authors.affiliation: Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. rbrachetcontul@ausl.vda.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Brachet Contul
authors.affiliation: Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. rbrachetcontul@ausl.vda.it.
authors.forename: Riccardo Brachet
authors.initials: RB
authors.lastname: Contul
authors.affiliation: Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. eponte@ausl.vda.it.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ponte
authors.affiliation: Department of General Surgery, Bariatric and Metabolic Unit, "Umberto Parini" Regional Hospital of Aosta, Viale Ginevra 3, Aosta, Italy. rallieta@ausl.vda.it.
authors.forename: Rosaldo
authors.initials: R
authors.lastname: Allieta
authors.affiliation: Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy. demanzini@units.it.
authors.forename: Nicolò
authors.initials: N
authors.lastname: de Manzini
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D057234:Preoperative Period; D011379:Prognosis; D012307:Risk Factors; D015431:Weight Loss; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Diabetes; Excess weight lost; Glycated hemoglobin; Laparoscopic gastric bypass; Predictive factors
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