title: Impaired weight loss in laparoscopic adjustable gastric banding patients over 50 years of age: diabetes mellitus as an independent risk factor.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) represents a safe and effective bariatric procedure, particularly for patients over 50. Preoperative risk factors for impaired post-LAGB excess weight loss are not well characterized for this population. This study aimed to identify demographics, characteristics or comorbidities associated with excess weight loss at 6 and 12 months postoperatively (EWL180 and EWL365, respectively) for these patients.
  
  
  METHODS
  One hundred and seventeen LAGB patients >50 years of age from 2005 to 2014 were retrospectively reviewed for factors potentially associated with EWL180 and EWL365. Rationally selected variables chosen for analysis included age, race, gender, initial body mass index and preoperative weight loss; comorbidities assessed included hypertension, psychiatric disorders and diabetes mellitus (DM). Variables correlated with EWL180 or EWL365 on bivariate linear regression analysis (P ≤ .05) were input into multivariate linear regression analysis to confirm independent association.
  
  
  RESULTS
  Preoperative DM (B = -9.1% EWL; 95% CI -13.6, -4.5%; P < .001) and African-American race (B = -8.8% EWL; 95% CI -17.3, -0.3%; P = .05) were independent risk factors for impaired EWL180. Only DM was a risk factor for impaired EWL365 (B = -9.7% EWL; 95% CI -17.7, -1.8%; P = .02).
  
  
  CONCLUSIONS
  LAGB is a successful operation in patients >50 years of age. Preoperative DM is an independent risk factor for impaired EWL in this cohort.
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, 1161 21st Ave S, MCN T2121, Nashville, TN, 37232-2730, USA. eric.s.wise@vanderbilt.edu.|Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA. eric.s.wise@vanderbilt.edu.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Wise
authors.affiliation: Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Sarwat
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Travis R
authors.initials: TR
authors.lastname: Ladner
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, 1161 21st Ave S, MCN T2121, Nashville, TN, 37232-2730, USA.|Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Hocking
authors.affiliation: Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Kavic
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric; Gastric banding; Laparoscopy; Obesity