Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study

Author(s):Show less -

Gil, Saulo ^[1] ; Goessler, Karla ^[1] ; Dantas, Wagner S. ^{[1, 2]} ; Murai, Igor Hisashi ^[1] ; Merege-Filho, Carlos Alberto Abujabra ^[1] ; Pereira, Rosa Maria R. ^[3] ; de Cleva, Roberto ^[4] ; Santo, Marco Aurelio ^[4] ; Kirwan, John P. ^[2] ; Roschel, Hamilton ^[1] ; Gualano, Bruno ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Med FMUSP, Sch Phys Educ & Sport, Appl Physiol & Nutr Res Grp, Sao Paulo - Brazil

^[2] Pennington Biomed Res Ctr, Integrated Physiol & Mol Med Lab, 6400 Perkins Rd, Baton Rouge, LA 70808 - USA

^[3] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Rheumatol Div, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Dept Digest Surg, Sao Paulo - Brazil

• Document type: Journal article
• Source: FRONTIERS IN PHYSIOLOGY; v. 12, JUN 11 2021.
• Web of Science Citations: 0

Abstract

Purpose The 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. Methods In 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. Results A total of 42 patients who had complete bodyweight data (age = 40 +/- 8 year; BMI = 47.8 +/- 7.1 kg/m(2)) 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 mu g/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. Conclusion Weight 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. (AU)

• FAPESP's process: 19/18039-7 - Reducing sedentary time in bariatric patients: a randomized controlled trial
• Grantee: Karla Fabiana Goessler
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 16/10993-5 - Effects of exercise training in patients undergoing bariatric surgery: a randomized and clinical trial
• Grantee: Hamilton Augusto Roschel da Silva
• Support Opportunities: Regular Research Grants