Predictors of weight loss after bariatric surgery—a cross-disciplinary approach combining physiological, social, and psychological measures

Nielsen, Mette S.; Christensen, Bodil; Schmidt, Julie Berg; Tækker, Louise; Holm, Lotte; Lunn, Susanne; Ritz, Christian; Albrechtsen, Nicolai J. Wewer; Holst, Jens J.; Schnurr, Theresia M.; Hansen, Torben; Roux, Carel W. le; Lund, Thomas Bøker; Floyd, Andrea Karen; Sjödin, Anders

doi:10.1038/s41366-020-0576-9

Cited by 32 publications

(30 citation statements)

References 51 publications

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“…The fact that the results are non-significant for the fourth year of follow-up may be explained by missing data due to loss to follow-up, which decreases the power for finding any significant difference. Despite not being in accordance with some studies in this area ( 13 – 15 ), our results are in accordance with the results described by Casas-Tapia et al at 1 year post-vertical gastrectomy ( 17 ). This might be due to the anabolic role of insulin ( 32 ).…”

Section: Discussionsupporting

confidence: 53%

“…For instance, Parri et al and Shantavasinkul et al found no difference concerning weight loss in patients with and without diabetes ( 13 , 14 ). Notwithstanding, Nielsen et al found that patients without T2DM lost more weight after gastric bypass surgery ( 15 ). Also, Souteiro et al showed that patients with complete diabetes remission after bariatric surgery lost more weight ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

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Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery

et al. 2021

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BackgroundObesity is a multifactorial disease, which is strongly associated to other metabolic disorders. Bariatric surgery is the most effective treatment of morbid obesity. The role of beta cell function in weight loss after bariatric surgery is uncertain.AimTo evaluate the association between beta cell function and percentage of total body weight loss (TBWL%) 1, 2, 3, and 4 years after bariatric surgery in patients with morbid obesity.MethodsRetrospective longitudinal study in patients with morbid obesity followed in our center between January 2010 and July 2018. Patients were excluded if they had diabetes at baseline or missing data on the needed parameters. We evaluated baseline Homeostatic Model Assessment of IR, Homeostatic Model Assessment of β-cell function (HOMA-beta), Quantitative Insulin Sensitivity Check Index, and Matsuda and DeFronzo index, and TBWL% at years 1 to 4. Linear regression models were used to evaluate the association of indexes of insulin resistance with TBWL% (unadjusted and adjusted for age, sex, BMI, and type of surgery).ResultsThere were 1,561 patients included in this analysis. HOMA-beta was negatively associated with TBWL% at second, third, and fourth years post-surgery (β = −1.04 [−1.82 to −0.26], p<0.01; β = −1.16 [−2.13 to −0.19], p=0.02; β = −1.29 [−2.64 to 0.06], p=0.061, respectively). This was not observed in the first year post-surgery nor for the other indexes. Glycemia at baseline was positively associated to EWL% at second and third years post-surgery.Conclusionβ-cell function at baseline seems to be associated to long-term weight loss, explicitly after the first year post bariatric surgery. This might be a helpful predictor of weight loss in clinical practice.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery

et al. 2021

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“…Finally, it should be borne in mind that a multitude of factors influence weight loss after bariatric surgery, like procedure of surgery, postprandial gastrointestinal hormone responses, diabetes status, preoperative eating disturbances, postoperative eating pattern and adaptive changes of the intestinal microbiota [35][36][37]. The many factors makes it challenging to disentangle the different effects including the potential roles of the GRSs.…”

Section: Plos Onementioning

confidence: 99%

Genetic markers of abdominal obesity and weight loss after gastric bypass surgery

et al. 2021

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Background Weight loss after bariatric surgery varies widely between individuals, partly due to genetic differences. In addition, genetic determinants of abdominal obesity have been shown to attenuate weight loss after dietary intervention with special attention paid to the rs1358980-T risk allele in the VEGFA locus. Here we aimed to test if updated genetic risk scores (GRSs) for adiposity measures and the rs1358980-T risk allele are linked with weight loss following gastric bypass surgery. Methods Five hundred seventy six patients with morbid obesity underwent Roux-en-Y gastric bypass. A GRS for BMI and a GRS for waist-hip-ratio adjusted for BMI (proxy for abdominal obesity), respectively, were constructed. All patients were genotyped for the rs1358980-T risk allele. Associations between the genetic determinants and weight loss after bariatric surgery were evaluated. Results The GRS for BMI was not associated with weight loss (β = -2.0 kg/100 risk alleles, 95% CI -7.5 to 3.3, p = 0.45). Even though the GRS for abdominal obesity was associated with an attenuated weight loss response adjusted for age, sex and center (β = -14.6 kg/100 risk alleles, 95% CI -25.4 to -3.8, p = 0.008), it was not significantly associated with weight loss after adjustment for baseline BMI (β = -7.9 kg/100 risk alleles, 95% CI -17.5 to 1.6, p = 0.11). Similarly, the rs1358980-T risk allele was not significantly associated with weight loss (β = -0.8 kg/risk allele, 95% CI -2.2 to 0.6, p = 0.25). Discussion GRSs for adiposity derived from large meta-analyses and the rs1358980-T risk allele in the VEGFA locus did not predict weight loss after gastric bypass surgery. The association between a GRS for abdominal obesity and the response to bariatric surgery may be dependent on the association between the GRS and baseline BMI.

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“…In addition, bariatric surgery provides an important option for effective weight loss, but the therapeutic response to surgery varies considerably among individuals [25]. Currently, the endeavor to address this variation in weight loss has proven to be less fruitful [26]. A hypothesis is thus raised in this study that the quality of VAT may have a close relationship with MetS and surgical response.…”

Section: Introductionmentioning

confidence: 96%

Deciphering CT texture features of human visceral fat to evaluate metabolic disorders and surgery-induced weight loss effects

et al. 2021

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Background: Metabolic syndrome (MetS) is highly related to the excessive accumulation of visceral adipose tissue (VAT). Quantitative measurements of VAT are commonly applied in clinical practice for measurement of metabolic risks; however, it remains largely unknown whether the texture of VAT can evaluate visceral adiposity, stratify MetS and predict surgery-induced weight loss effects. Methods: 675 Chinese adult volunteers and 63 obese patients (with bariatric surgery) were enrolled. Texture features were extracted from VATs of the computed tomography (CT) scans and machine learning was applied to identify significant imaging biomarkers associated with metabolic-related traits. Findings: Combined with sex, ten VAT texture features achieved areas under the curve (AUCs) of 0.872, 0.888, 0.961, and 0.947 for predicting the prevalence of insulin resistance, MetS, central obesity, and visceral obesity, respectively. A novel imaging biomarker, RunEntropy, was identified to be significantly associated with major metabolic outcomes and a 3.5-year follow-up in 338 volunteers demonstrated its long-term effectiveness. More importantly, the preoperative imaging biomarkers yielded high AUCs and accuracies for estimation of surgery responses, including the percentage of excess weight loss (%EWL) (0.867 and 74.6%), postoperative BMI group (0.930 and 76.1%), postoperative insulin resistance (0.947 and 88.9%), and excess visceral fat loss (the proportion of visceral fat reduced over 50%; 0.928 and 84.1%). Interpretation: This study shows that the texture features of VAT have significant clinical implications in evaluating metabolic disorders and predicting surgery-induced weight loss effects. Funding: The complete list of funders can be found in the Acknowledgement section.

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Predictors of weight loss after bariatric surgery—a cross-disciplinary approach combining physiological, social, and psychological measures

Cited by 32 publications

References 51 publications

Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery

Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery

Genetic markers of abdominal obesity and weight loss after gastric bypass surgery

Deciphering CT texture features of human visceral fat to evaluate metabolic disorders and surgery-induced weight loss effects

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