Sarah Ying Tse Tan1, Nicholas L Syn2, Daryl J Lin2, Chin Hong Lim3,4, Sonali Ganguly1,4, Hock Soo Ong3, Jeremy Tian Hui Tan3,4, Phong Ching Lee5,6. 1. Department of Endocrinology, Singapore General Hospital, Singapore, Singapore. 2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 3. Department of Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital, Singapore, Singapore. 4. Obesity Centre, Outram Community Hospital SGH, Specialist Outpatient Clinic SingHealth Tower, Level 3, 10 Hospital Blvd, Singapore, 168582, Singapore. 5. Department of Endocrinology, Singapore General Hospital, Singapore, Singapore. lee.phong.ching@singhealth.com.sg. 6. Obesity Centre, Outram Community Hospital SGH, Specialist Outpatient Clinic SingHealth Tower, Level 3, 10 Hospital Blvd, Singapore, 168582, Singapore. lee.phong.ching@singhealth.com.sg.
Abstract
BACKGROUND: Following bariatric surgery, accurate charting of weight loss and regain is crucial. Various preoperative factors affect postoperative weight loss, including age, sex, ethnicity, and surgical type. These are not considered by current weight loss metrics, limiting comparison of weight loss outcomes between patients or centers and across time. METHODS: Patients (n=1022) who underwent sleeve gastrectomy (n=809) and gastric bypass (n=213) from 2008 to 2020 in a single center were reviewed. Weight loss outcomes (% total weight loss) were measured for 60 months postoperatively. Longitudinal centile lines were plotted using the post-estimation predictions of quantile regression models, adjusted for type of procedure, sex, ethnicity, and baseline BMI. RESULTS: Median regression showed that %TWL was 1.0% greater among males than females (β = +1.1, 95% CI: +0.6 to +1.7, P = <0.0001). Participants who underwent SG had less %TWL compared to GB (β = -1.3, 95% CI: -1.9 to -0.8, P < 0.0001). There was a trend towards less %TWL among the Indian and Malay participants compared to Chinese. Age and diabetes were not significant predictors. Reference centile charts were produced for the overall cohort, as well as specific charts adjusted for type of bariatric procedure, sex, ethnicity, and baseline BMI. CONCLUSION: Centile charts provide a clinically relevant method for monitoring of weight trajectories postoperatively and aid in realistic and personalised goal setting, and the early identification of "poor responders". This is the first study to present post-bariatric surgery centile charts for an Asian cohort.
BACKGROUND: Following bariatric surgery, accurate charting of weight loss and regain is crucial. Various preoperative factors affect postoperative weight loss, including age, sex, ethnicity, and surgical type. These are not considered by current weight loss metrics, limiting comparison of weight loss outcomes between patients or centers and across time. METHODS:Patients (n=1022) who underwent sleeve gastrectomy (n=809) and gastric bypass (n=213) from 2008 to 2020 in a single center were reviewed. Weight loss outcomes (% total weight loss) were measured for 60 months postoperatively. Longitudinal centile lines were plotted using the post-estimation predictions of quantile regression models, adjusted for type of procedure, sex, ethnicity, and baseline BMI. RESULTS: Median regression showed that %TWL was 1.0% greater among males than females (β = +1.1, 95% CI: +0.6 to +1.7, P = <0.0001). Participants who underwent SG had less %TWL compared to GB (β = -1.3, 95% CI: -1.9 to -0.8, P < 0.0001). There was a trend towards less %TWL among the Indian and Malay participants compared to Chinese. Age and diabetes were not significant predictors. Reference centile charts were produced for the overall cohort, as well as specific charts adjusted for type of bariatric procedure, sex, ethnicity, and baseline BMI. CONCLUSION: Centile charts provide a clinically relevant method for monitoring of weight trajectories postoperatively and aid in realistic and personalised goal setting, and the early identification of "poor responders". This is the first study to present post-bariatric surgery centile charts for an Asian cohort.
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Authors: Nicholas L Syn; David E Cummings; Louis Z Wang; Daryl J Lin; Joseph J Zhao; Marie Loh; Zong Jie Koh; Claire Alexandra Chew; Ying Ern Loo; Bee Choo Tai; Guowei Kim; Jimmy Bok-Yan So; Lee M Kaplan; John B Dixon; Asim Shabbir Journal: Lancet Date: 2021-05-06 Impact factor: 79.321
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