title: Predictors of metabolic syndrome persistence 1 year after laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) is effective in reversing the metabolic syndrome (MS) in up to 90% of patients.
  
  
  OBJECTIVE
  The aim of this study was to determine predictors of MS persistence 1 year after LRYGB.
  
  
  METHODS
  University Hospital, France.
  
  
  METHODS
  Ninety-one patients with a mean age of 44.4 years and a mean body mass index (BMI) of 43.1 kg/m² meeting the criteria for MS were enrolled in this prospective study. Anthropometric, metabolic, and inflammatory biological parameters were assessed before and 1 year after LRYGB. Patients were divided into 2 groups according to the persistence (MS nonresponders) or resolution of MS (MS responders) 1 year after LRYGB and a comparison was performed at baseline and 1 year after surgery.
  
  
  RESULTS
  Sixty-nine patients (75.8%) underwent remission, while 22 (24.2%) showed persistence of MS 1 year after LRYGB. At baseline the MS nonresponders group presented significantly higher values of fasting plasma glucose (7.8 versus 5.3 mmol/L, P = .004), glycosylated hemoglobin (HbA1c, 7.3% versus 5.9%, P = .0004), triglycerides (TG, 2.37 versus 1.33 mmol/L, P = .006), and homeostasis model assessment of insulin resistance (HOMA-IR, 442.5 versus 256, P = .006). The rate of diabetes was significantly higher in this group (68.2% versus 36.8%, P = .0086), as well as the number of MS components per patient. One year after LRYGB, the MS nonresponders showed a significantly lower excess BMI lost (EBMIL) (56.1% versus 82.4%, P = .00008). On multivariate analysis, baseline levels of TG, glucose metabolism markers and EBMIL were associated with the persistence of MS.
  
  
  CONCLUSIONS
  Baseline levels of TG, plasma fasting glucose, and HbA1c, as well as history of type 2 diabetes and EBMIL, represent predictors of MS persistence 1 year after LRYGB.
authors: University Hospital of Nice, Digestive Center, Nice, France; University of Nice-Sophia-Antipolis, Faculty of Medicine, Nice, France. Electronic address: framartini77@hotmail.com.
authors: Francesco
authors: F
authors: Martini
authors: University Hospital of Nice, Digestive Center, Nice, France; University of Nice-Sophia-Antipolis, Faculty of Medicine, Nice, France; Institut National de la Santé et de la Recherche Médicale (INSERM), U1065, Team 8, Hepatic Complications in Obesity, Nice, France.
authors: Rodolphe
authors: R
authors: Anty
authors: University Hospital of Nice, Digestive Center, Nice, France; University of Nice-Sophia-Antipolis, Faculty of Medicine, Nice, France; Institut National de la Santé et de la Recherche Médicale (INSERM), U1065, Team 8, Hepatic Complications in Obesity, Nice, France.
authors: Anne-Sophie
authors: AS
authors: Schneck
authors: University Hospital of Nice, Digestive Center, Nice, France; University of Nice-Sophia-Antipolis, Faculty of Medicine, Nice, France.
authors: Vincent
authors: V
authors: Casanova
authors: University Hospital of Nice, Digestive Center, Nice, France; University of Nice-Sophia-Antipolis, Faculty of Medicine, Nice, France; Institut National de la Santé et de la Recherche Médicale (INSERM), U1065, Team 8, Hepatic Complications in Obesity, Nice, France.
authors: Antonio
authors: A
authors: Iannelli
authors: University Hospital of Nice, Digestive Center, Nice, France; University of Nice-Sophia-Antipolis, Faculty of Medicine, Nice, France; Institut National de la Santé et de la Recherche Médicale (INSERM), U1065, Team 8, Hepatic Complications in Obesity, Nice, France.
authors: Jean
authors: J
authors: Gugenheim
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005602:France; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
keywords: Excess weight loss; Glucose metabolism markers; Metabolic syndrome; Predictors; Roux-en-Y gastric bypass; Triglycerides