| Purpose:Weight loss results after bariatric surgery vary greatly among individuals,and weight loss results vary among different groups.Therefore,for obese people,when choosing a treatment plan,not only weight control should be taken into account,but also a comprehensive analysis of various information such as the patient’s physical characteristics and individual factors.The purpose of this paper is to investigate the relationship between the results of weight loss surgery and the degree of preoperative obesity in obese patients,and to analyze the differences in this relationship between different genders and the changes in glycolipid metabolism caused by surgery.Methods:Retrospectively analyzed the information of 308 obese patients who underwent laparoscopic sleeve gastrectomy(LSG)in our hospital from October 2016 to November2021,including 223(72.4%)females and 85(27.6%)males.Information was collected on the patients’preoperative and postoperative follow-up at 1,3,6 months.It mainly included patients’general conditions(height,weight,chest circumference,waist circumference,hip circumference,upper arm circumference,thigh circumference)and glucolipid metabolic indexes.Data for continuous variables were expressed as mean±standard deviation(SD),and data for categorical variables were expressed as total and percentage.Chi-squared test,independent samples t-test and Mann-Whitney U-test were used to compare categorical,normally distributed and skewed continuous variables in men and women.Repeated measures were analyzed using mixed models.Generalized linear regression models were applied to assess the association between TWL%and preoperative BMI in obese patients in both unadjusted and multivariate adjusted models.In addition,nonlinear relationships were explored with generalized additive models(GAM).Results:Men participating in LSG presented a higher BMI(42.56.8 kg/m~2)and a higher prevalence of hypertension and diabetes(67.1%and 31.3%for men and women,respectively).All patients involved in BS demonstrated a significant decrease in body mass index(BMI)and a non-linear relationship between preoperative BMI and percentage of total weight loss(%TWL).Using a two-stage linear regression model,in male patients we calculated an inflection point of 50.28 kg/m2.the effect size,95%CI and P-value for the left side of the inflection point were 0.21,-0.25 to 0.67 and 0.3839,respectively.when BMI was 50.28 kg/m~2,%TWL was found to be significantly associated with BMI on the right side of the inflection point(1.38,0.16 to 2.60,P=0.0392).In female patients,we calculated the inflection point to be 35.00 kg/m~2.On the right side of the inflection point,%TWL was negatively correlated with BMI(-0.371,-0.710 to-0.033,P=0.0358).The patients’glucolipid metabolic function improved after bariatric surgery,with a decrease in blood glucose,glycated hemoglobin and an increase in high-density lipoprotein cholesterol(HDL-C)compared to preoperative levels,in addition to a decrease in uric acid levels(UA).Conclusions:After performing BS in obese patients,it significantly reduces the patient’s weight afterwards,and the%TWL of obese patients curves with the increase of body mass index.Specifically in male patients%TWL increases with increasing BMI,but in female patients there is a tendency for%TWL to increase and then decrease with increasing BMI.In contrast,sex hormone levels,basal metabolic rate and whether the woman has ever had a childbearing status may be influential factors.However,this needs to be confirmed in further studies.In addition,weight loss surgery has shown significant improvements in glycolipid and other metabolic functions. |
PDF Full Text Request