1.Minimally Invasive Surgery Research Center, Hazrat-E Rasool General Hospital, Iran University of Medical Sciences, Masouri St. Niyayesh St. Satarkhan Ave, Tehran, Iran ;2.Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran ;3.Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran ;4.Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran ;5.Mental Health Center Ballerup, Baraye Affinity, Ballerup, Denmark ;6.Student in Molecular Cell Biology and Data Science, University of California, Berkeley, San Francisco, CA, USA ;
Abstract:
Background
Weight regain (WR) and insufficient weight loss (IWL) after sleeve gastrectomy (SG) are challenging issues. This study aimed to evaluate the predictors of WR and IWL after SG.
Methods
In this retrospective analytical study, 568 patients who underwent SG at Hazrat-e Rasool General Hospital, Tehran, Iran, between January 2015 and April 2022 were evaluated. A total of 333 patients were included. WR and IWL were evaluated by multiple criteria such as a BMI of?>?35 kg/m2, an increase in BMI of?>?5 kg/m2 above nadir, an increase in weight of?>?10 kg above nadir, percentage of excess weight loss (%EWL)?<?50% at 18 months, an increase in weight of?>?25% of EWL from nadir at 36 months, and percentage of total weight loss (%TWL)?<?20% at 36 months. All participants were followed up for 36 months.
Result
The univariate analysis showed that preoperative BMI, obstructive sleep apnea, metformin consumption, and grades 2 and 3 fatty liver disease were associated with WR and IWL (P?<?0.05). WR or IWL incidence varied (0–19.3%) based on different definitions. The multivariate analysis showed that a preoperative BMI of?>?45 kg/m2 odds ratioAdjusted (ORAdj) 1.77, 95% CI: 1.12–4.11, P?=?0.038] and metformin consumption ORAdj: 0.48, 95% CI: 0.19–0.78, P?=?0.001] were associated with WR and IWL after SG, regardless of the definition of WR or IWL.
Conclusion
This study showed that preoperative BMI of?>?45 kg/m2, obstructive sleep apnea, metformin consumption, and grades 2 and 3 of fatty liver disease were associated with WR or IWL.