Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study
PurposeThe aim of this exploratory study was to investigate whether the degree of weight loss properly reflects improvements in cardiometabolic health among patients who underwent Roux-en-Y gastric bypass.MethodsIn this ancillary analysis from a clinical trial, patients were clustered into tertiles...
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2021.640191/full |
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| author | Saulo Gil Karla Goessler Wagner S. Dantas Wagner S. Dantas Igor Hisashi Murai Carlos Alberto Abujabra Merege-Filho Rosa Maria R. Pereira Roberto de Cleva Marco Aurélio Santo John P. Kirwan Hamilton Roschel Bruno Gualano |
| author_facet | Saulo Gil Karla Goessler Wagner S. Dantas Wagner S. Dantas Igor Hisashi Murai Carlos Alberto Abujabra Merege-Filho Rosa Maria R. Pereira Roberto de Cleva Marco Aurélio Santo John P. Kirwan Hamilton Roschel Bruno Gualano |
| author_sort | Saulo Gil |
| collection | DOAJ |
| description | PurposeThe aim of this exploratory study was to investigate whether the degree of weight loss properly reflects improvements in cardiometabolic health among patients who underwent Roux-en-Y gastric bypass.MethodsIn this ancillary analysis from a clinical trial, patients were clustered into tertiles according to the magnitude of the percentage weight loss (1st tertile: “higher weight loss”: −37.1 ± 5.8%; 2nd tertile: “moderate weight loss”: −29.7 ± 1.4%; 3rd tertile: “lower weight loss”: −24.2 ± 2.3%). Delta changes (9 months after surgery-baseline) in clustered cardiometabolic risk (i.e., blood pressure index, fasting glucose, high-density lipoprotein [HDL] and triglycerides [TG]), glycated hemoglobin (HbA1c), homeostasis model assessment (HOMA-IR), and C-reactive protein (CRP) were calculated.ResultsA total of 42 patients who had complete bodyweight data (age = 40 ± 8 year; BMI = 47.8 ± 7.1 kg/m2) were included. Surgery led to substantial weight loss (−37.9 ± 11.3 kg, P < 0,001), and clinically significant improvements in blood pressure index (−17.7 ± 8.2 mmHg, P < 0.001), fasting glucose (−36.6 ± 52.5 mg/dL, P < 0.001), HDL (9.4 ± 7.1 mg/dL, P < 0.001), TG (−35.8 ± 44.1 mg/dL P < 0,001), HbA1c (−1.2 ± 1.6%, P < 0.001), HOMA-IR (−4.7 ± 3.9 mg/dL, P < 0.001) and CRP (−8.5 ± 6.7 μg/mL P < 0.001). Comparisons across tertiles revealed no differences for cardiometabolic risk score, fasting glucose, HbAc1, HOMA-IR, blood pressure index, CRP, HDL, and TG (P > 0.05 for all). Individual variable analysis confirmed cardiometabolic improvements across the spectrum on weight-loss. There were no associations between weight loss and any dependent variable.ConclusionWeight loss following bariatric surgery does not correlate with improvements in cardiovascular risk factors. These findings suggest that weight loss alone may be insufficient to assess the cardiometabolic success of bariatric surgery, and the search for alternate proxies that better predict surgery success are needed. |
| first_indexed | 2024-12-17T06:32:54Z |
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| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-17T06:32:54Z |
| publishDate | 2021-06-01 |
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| spelling | doaj.art-73b9af580b35443390689447eae0041f2022-12-21T22:00:06ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-06-011210.3389/fphys.2021.640191640191Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory StudySaulo Gil0Karla Goessler1Wagner S. Dantas2Wagner S. Dantas3Igor Hisashi Murai4Carlos Alberto Abujabra Merege-Filho5Rosa Maria R. Pereira6Roberto de Cleva7Marco Aurélio Santo8John P. Kirwan9Hamilton Roschel10Bruno Gualano11Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BrazilApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BrazilApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BrazilIntegrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United StatesApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BrazilApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BrazilRheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDepartment of Digestive Surgery, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilDepartment of Digestive Surgery, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BrazilIntegrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United StatesApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BrazilApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, BrazilPurposeThe aim of this exploratory study was to investigate whether the degree of weight loss properly reflects improvements in cardiometabolic health among patients who underwent Roux-en-Y gastric bypass.MethodsIn this ancillary analysis from a clinical trial, patients were clustered into tertiles according to the magnitude of the percentage weight loss (1st tertile: “higher weight loss”: −37.1 ± 5.8%; 2nd tertile: “moderate weight loss”: −29.7 ± 1.4%; 3rd tertile: “lower weight loss”: −24.2 ± 2.3%). Delta changes (9 months after surgery-baseline) in clustered cardiometabolic risk (i.e., blood pressure index, fasting glucose, high-density lipoprotein [HDL] and triglycerides [TG]), glycated hemoglobin (HbA1c), homeostasis model assessment (HOMA-IR), and C-reactive protein (CRP) were calculated.ResultsA total of 42 patients who had complete bodyweight data (age = 40 ± 8 year; BMI = 47.8 ± 7.1 kg/m2) were included. Surgery led to substantial weight loss (−37.9 ± 11.3 kg, P < 0,001), and clinically significant improvements in blood pressure index (−17.7 ± 8.2 mmHg, P < 0.001), fasting glucose (−36.6 ± 52.5 mg/dL, P < 0.001), HDL (9.4 ± 7.1 mg/dL, P < 0.001), TG (−35.8 ± 44.1 mg/dL P < 0,001), HbA1c (−1.2 ± 1.6%, P < 0.001), HOMA-IR (−4.7 ± 3.9 mg/dL, P < 0.001) and CRP (−8.5 ± 6.7 μg/mL P < 0.001). Comparisons across tertiles revealed no differences for cardiometabolic risk score, fasting glucose, HbAc1, HOMA-IR, blood pressure index, CRP, HDL, and TG (P > 0.05 for all). Individual variable analysis confirmed cardiometabolic improvements across the spectrum on weight-loss. There were no associations between weight loss and any dependent variable.ConclusionWeight loss following bariatric surgery does not correlate with improvements in cardiovascular risk factors. These findings suggest that weight loss alone may be insufficient to assess the cardiometabolic success of bariatric surgery, and the search for alternate proxies that better predict surgery success are needed.https://www.frontiersin.org/articles/10.3389/fphys.2021.640191/fullgastric bypasscardiometabolic risk (factors)metabolic healthobesityweight loss |
| spellingShingle | Saulo Gil Karla Goessler Wagner S. Dantas Wagner S. Dantas Igor Hisashi Murai Carlos Alberto Abujabra Merege-Filho Rosa Maria R. Pereira Roberto de Cleva Marco Aurélio Santo John P. Kirwan Hamilton Roschel Bruno Gualano Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study Frontiers in Physiology gastric bypass cardiometabolic risk (factors) metabolic health obesity weight loss |
| title | Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study |
| title_full | Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study |
| title_fullStr | Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study |
| title_full_unstemmed | Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study |
| title_short | Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study |
| title_sort | constraints of weight loss as a marker of bariatric surgery success an exploratory study |
| topic | gastric bypass cardiometabolic risk (factors) metabolic health obesity weight loss |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2021.640191/full |
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