Long-Term Weight Loss Outcome of Laparoscopic Sleeve Gastrectomy Predicted by the Percentage of Excess Weight Loss at 6 Months in Chinese Patients with Body Mass Index ≥ 32.5 Kg/m²

Abstract

Purpose

To evaluate the predictive effect of the initial weight loss on the long-term weight loss in Chinese patients with a body mass index (BMI) ≥ 32.5 kg/m² who underwent LSG.

Patients and Methods

The follow-up was completed via phone or WeChat for outpatients and at the hospital for inpatients. We evaluated the BMI, percentage of excess weight loss (%EWL), and type 2 diabetes mellitus, hypertension, and hyperlipidemia statuses. Linear and logistic regression analyses were performed on the relationship between the initial and long-term weight loss. The optimal cut-off value was determined by receiver operating characteristic (ROC) curve analysis.

Results

We enrolled 307 patients, with a median preoperative BMI of 39.68 (35.68, 45.47) kg/m². %EWL ≥ 50% was regarded as successful weight loss, and 76.55% of the patients lost their weight successfully. (Reviewer #1, comment #4) %EWL at 6 months and 5 years were positively correlated (P < 0.001). Further, the following linear equation could express the relationship: (%EWL_{5 years} = 29.193 + 0.526 × %EWL_{6 months}). %EWL ≥ 58.57% at 6 months was the best predictor of successful weight loss at 5 years after LSG (Reviewer #1, comment #5) (sensitivity, 73.62%; specificity, 73.61%; AUC value, 0.780). Internal verification of the prediction model revealed satisfactory results in terms of discrimination and calibration.

Conclusion

In Chinese patients with BMI ≥ 32.5 kg/m² who underwent LSG, %EWL at 6 months and 5 years were correlated. %EWL ≥ 58.57% at 6 months was a predictor of successful long-term weight loss.

Keywords:

• laparoscopic sleeve gastrectomy
• obesity
• weight loss
• prognosis

Acknowledgments

This article was supported by Beijing Municipal Science & Technology Commission, No. Z191100006619043 and Clinical Cooperation Ability Construction Project of Chinese and Western Medicine for Major and Difficult Diseases (Department of Medical Administration, National Administration of Traditional Chinese Medicine [2018] No. 3).

The authors would like to thank all the reviewers who participated in the article, as well as MJEditor(www.mjeditor.com) for providing English editing services during the preparation of this manuscript. Liang Wang, Chenxu Tian, Guangzhong Xu are co-first authors.

Disclosure

The authors declare that they have no conflicts of interest.