Predicting Maximum Roux-en-Y Gastric Bypass-Induced Weight Reduction — Preoperative Plasma Leptin or Body Weight?

Czupryniak, Leszek; Pawłowski, Maciej; Kumor, Anna; Szymański, Dariusz; Loba, Jerzy; Strzelczyk, Janusz

doi:10.1007/s11695-007-9042-1

Cited by 25 publications

(28 citation statements)

References 28 publications

(26 reference statements)

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“…A recent study showed that preoperative plasma leptin concentration cannot be used as a predictor of weight reduction after RYGBP [10]. Our result was consistent with their study that the baseline leptin level was not predictive of %EBL 1 year after LMGBP surgery.…”

Section: Discussionsupporting

confidence: 92%

“…Several studies showed that larger BMI had increased odds of below average %EWL and lower baseline weight predicted greater weight loss [6,8,9,28]. On the other hand, some studies showed that larger baseline body weight was associated with greater maximum absolute weight reduction [10]. Our study was consistent with the former studies that larger initial BMI was associated with lesser %EBL after LMGBP [6,8,9,28].…”

Section: Discussionsupporting

confidence: 91%

“…The contradictory results was probably related to the different methods used to report weight reduction. The former studies [6,8,9,28] used %EWL, whereas the latter study [10] used weight reduction alone (not divided by "preoperative weight minus ideal body weight") to represent the extent of weight reduction. In our study, if we used weight reduction alone instead of %EBL as a measurement for weight loss, we found that greater preoperative BMI was associated with greater weight reduction.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies found that lower baseline weight predicted greater weight loss [8] and single patients with BMI <50 had the best chance of achieving greater weight loss [9]. However, a recent study reported that baseline body weight was positively correlated with maximum absolute weight reduction [10].…”

Section: Introductionmentioning

confidence: 99%

“…Changes in leptin concentrations are also correlated with changes in subcutaneous, visceral, and total adipose tissues [14]. However, a recent study reported that preoperative plasma leptin concentration could not be used as a predictor of weight reduction after RYGBP [10]. Ghrelin, which is mainly produced in the stomach, was reported to be inversely correlated with BMI [15].…”

Section: Introductionmentioning

confidence: 99%

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The Serial Changes of Ghrelin and Leptin Levels and Their Relations to Weight Loss After Laparoscopic Minigastric Bypass Surgery

et al. 2007

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Serial Changes of Ghrelin and Leptin Levels and Their Relations to Weight Loss After Laparoscopic Minigastric Bypass Surgery

et al. 2007

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Long-term Follow-up After Bariatric Surgery

Puzziferri

Roshek

Mayo

et al. 2014

JAMA

735

418

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IMPORTANCE Bariatric surgery is an accepted treatment for obesity. Despite extensive literature, few studies report long-term follow-up in cohorts with adequate retention rates. OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss, type 2 diabetes, hypertension, and hyperlipidemia in severely obese adults. EVIDENCE REVIEW MEDLINE and Cochrane databases were searched from 1946 through May 15, 2014. Search terms included bariatric surgery, individual bariatric procedures, and obesity. Studies were included if they described outcomes for gastric bypass, gastric band, or sleeve gastrectomy performed on patients with a body mass index of 35 or greater, had more than 2 years of outcome information, and had follow-up measures for at least 80% of the initial cohort. Two investigators reviewed each study and a third resolved study inclusion disagreements. FINDINGS Of 7371 clinical studies reviewed, 29 studies (0.4%, 7971 patients) met inclusion criteria. All gastric bypass studies (6 prospective cohorts, 5 retrospective cohorts) and sleeve gastrectomy studies (2 retrospective cohorts) had 95% confidence intervals for the reported mean, median, or both exceeding 50% excess weight loss. This amount of excess weight loss occurred in 31% of gastric band studies (9 prospective cohorts, 5 retrospective cohorts). The mean sample-size–weighted percentage of excess weight loss for gastric bypass was 65.7% (n = 3544) vs 45.0% (n = 4109) for gastric band. Nine studies measured comorbidity improvement. For type 2 diabetes (glycated hemoglobin <6.5% without medication), sample-size–weighted remission rates were 66.7% for gastric bypass (n = 428) and 28.6% for gastric band (n = 96). For hypertension (blood pressure <140/90 mm Hg without medication), remission rates were 38.2% for gastric bypass (n = 808) and 17.4% for gastric band (n = 247). For hyperlipidemia (cholesterol <200 mg/dL, high-density lipoprotein >40 mg/dL, low-density lipoprotein <160 mg/dL, and triglycerides <200 mg/dL), remission rates were 60.4% for gastric bypass (n = 477) and 22.7% for gastric band (n = 97). CONCLUSIONS AND RELEVANCE Very few bariatric surgery studies report long-term results with sufficient patient follow-up to minimize biased results. Gastric bypass has better outcomes than gastric band procedures for long-term weight loss, type 2 diabetes control and remission, hypertension, and hyperlipidemia. Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections.

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Hormone Changes Affecting Energy Homeostasis after Metabolic Surgery

Harvey

Arroyo

Körner

et al. 2010

Mount Sinai J Medicine

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Worldwide, there is an epidemic of obesity and its associated diseases. The past decade of research has brought about a paradigm shift in our understanding of both the mechanisms underlying energy homeostasis and the multiple factors contributing to the pathophysiology of obesity. Metabolic surgery is currently far more effective than diet and exercise or pharmacotherapy in achieving durable weight loss. Moreover, the remarkable results of surgery in achieving a rapid remission of type 2 diabetes mellitus has sparked tremendous excitement and research into the mechanisms through which metabolic surgery has its dramatic effect. As opposed to the traditional understanding of "restriction" and "malabsorption," current evidence suggests that metabolic surgery alters the expression of multiple hormones that affect both short-term and long-term signals of energy balance. We review the hormonal changes following the most common types of metabolic operations currently being performed. The profile of hormonal changes provides a guide to tailor the choice of operation for each individual patient toward achieving the desired metabolic result. In the future, individualized metabolic surgery alone or modulated by targeted pharmacological therapy may achieve the most reliable and effective results with the highest safety and lowest side effect profile.

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Predicting Maximum Roux-en-Y Gastric Bypass-Induced Weight Reduction — Preoperative Plasma Leptin or Body Weight?

Abstract: Preoperative plasma leptin concentration cannot be used as a predictor of weight reduction following RYGBP. Preoperative body weight is a reliable predictor of post-RYGBP weight loss.

Cited by 25 publications

References 28 publications

The Serial Changes of Ghrelin and Leptin Levels and Their Relations to Weight Loss After Laparoscopic Minigastric Bypass Surgery

The Serial Changes of Ghrelin and Leptin Levels and Their Relations to Weight Loss After Laparoscopic Minigastric Bypass Surgery

Long-term Follow-up After Bariatric Surgery

Hormone Changes Affecting Energy Homeostasis after Metabolic Surgery

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