Cristina Casas-Tapia1, Roger V Araujo-Castillo2, Lil Saavedra-Tafur3, Aimeé Bert-Dulanto2, Alejandro Piscoya4, Alberto Casas-Lucich5. 1. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú. Electronic address: cristinadlcasas@gmail.com. 2. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú. 3. Cirugía General, Endoscópica y Bariátrica, Clínica de Día Avendaño, Lima, Perú. 4. Dirección de Investigación, Universidad San Ignacio de Loyola, Lima, Perú; Servicio de Gastroenterología, Hospital Guillermo Kaelin de la Fuente, Lima, Perú. 5. Facultad de Ciencias de la Salud, Universidad Privada San Juan Bautista, Lima, Perú.
Abstract
INTRODUCTION: Bariatric surgery is considered the most effective treatment for severe obesity. However, it is not clear if patients with diabetes mellitus or insulin resistance have the same response than patients without those conditions. Our objective was to evaluate association between pre-surgical HOMA-IR index and percentage of excess weight loss (EWL%) one year after bariatric surgery using sleeve gastrectomy. METHODS: Retrospective cohort including patients ≥18 years old with BMI≥35kg/m2, who underwent primary sleeve gastrectomy between 2014-2017 at the Avendaño Medical Center, Peru. Only patients with Type 2 Diabetes, Hypertension, or Dyslipidemia were included. EWL% ≥60% one year after surgery was considered satisfactory. Crude and adjusted Lineal and Poisson regression with robustness was used to assess statistical associations with EWL%. RESULTS: Ninety-one patients were included with a median of 34 years, and 57.1% were women. 85.7% had insulin resistance as per HOMA-IR. One year after surgery, 76.9% had a satisfactory EWL%. The lineal model showed .29% less EWL% per each extra year of life (P=.019), and .93% more EWL% per each extra HOMA-IR point (P=.004). The adjusted Poisson model showed 2% lower risk of having a satisfactory EWL% per each additional year of life (P=.050), and 2% more chance of success per each additional HOMA-IR point (P=.038). CONCLUSIONS: There was association between a higher pre-surgical HOMA-IR index and increased EWL% one year after surgery. It is possible that insulin resistance does not affect negatively sleeve gastrectomy outcomes.
INTRODUCTION: Bariatric surgery is considered the most effective treatment for severe obesity. However, it is not clear if patients with diabetes mellitus or insulin resistance have the same response than patients without those conditions. Our objective was to evaluate association between pre-surgical HOMA-IR index and percentage of excess weight loss (EWL%) one year after bariatric surgery using sleeve gastrectomy. METHODS: Retrospective cohort including patients ≥18 years old with BMI≥35kg/m2, who underwent primary sleeve gastrectomy between 2014-2017 at the Avendaño Medical Center, Peru. Only patients with Type 2 Diabetes, Hypertension, or Dyslipidemia were included. EWL% ≥60% one year after surgery was considered satisfactory. Crude and adjusted Lineal and Poisson regression with robustness was used to assess statistical associations with EWL%. RESULTS: Ninety-one patients were included with a median of 34 years, and 57.1% were women. 85.7% had insulin resistance as per HOMA-IR. One year after surgery, 76.9% had a satisfactory EWL%. The lineal model showed .29% less EWL% per each extra year of life (P=.019), and .93% more EWL% per each extra HOMA-IR point (P=.004). The adjusted Poisson model showed 2% lower risk of having a satisfactory EWL% per each additional year of life (P=.050), and 2% more chance of success per each additional HOMA-IR point (P=.038). CONCLUSIONS: There was association between a higher pre-surgical HOMA-IR index and increased EWL% one year after surgery. It is possible that insulin resistance does not affect negatively sleeve gastrectomy outcomes.
Authors: Marta Borges-Canha; João Sérgio Neves; Fernando Mendonça; Maria Manuel Silva; Cláudia Costa; Pedro M Cabral; Vanessa Guerreiro; Rita Lourenço; Patrícia Meira; Daniela Salazar; Maria João Ferreira; Jorge Pedro; Ebrahim Barkoudah; Ana Sande; Eva Lau; Selma B Souto; John Preto; Paula Freitas; Davide Carvalho Journal: Front Endocrinol (Lausanne) Date: 2021-08-12 Impact factor: 5.555
Authors: C D'Eusebio; S Boschetti; F Rahimi; G Fanni; A De Francesco; M Toppino; M Morino; E Ghigo; S Bo Journal: J Endocrinol Invest Date: 2020-08-25 Impact factor: 4.256