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Baseline Anthropometric and Metabolic Parameters Correlate with Weight Loss in Women 1-Year After Laparoscopic Roux-En-Y Gastric Bypass

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An Erratum to this article was published on 05 July 2017

This article has been updated

Abstract

Background

In this study, we explored in a prospective cohort of morbidly obese women undergoing laparoscopic Roux-en-Y gastric bypass (LRYGP) correlations between baseline anthropometrics, metabolic parameters, resting energy expenditure (REE), body composition, and 1-year % excess body mass index loss (%EBMIL). We also investigated risk factors for insufficient %EBMIL.

Methods

One hundred three consecutive women were prospectively evaluated at baseline (age 40.6 ± 11.2, weight 113.9 kg ± 15.3, BMI 43.3 ± 4.9 kg/m2) and 1 year after LRYGP. Weight, excess weight, brachial circumference, waist circumference, fat mass (FM) and fat-free mass (FFM) (measured with bioelectrical impedance analysis), REE, inflammation, insulin resistance, and lipid disturbances were determined before and 1 year after LRYGP.

Results

At 1 year, mean weight loss was 39.8 kg ± 11.7 and mean EBMIL was 15.2 kg/m2 ± 4.2. Mean %EBMIL was 86% ± 21% (range 30–146%). Baseline brachial circumference, waist circumference and triceps skinfold thickness decreased significantly at 1 year (P < 0.001). Blood glucose and insulin levels, HDL cholesterol, LDL cholesterol, triglycerides, and CRP also decreased significantly (P < 0.001). The mean loss of initial FFM and FM was 9.1 kg ± 8.2 (15%) and 30.7 kg ± 11.8 (53%), respectively. REE on body weight ratio (REE/BW) increased from 15.3 kcal/kg ± 2.8 to 18.4 kcal/kg ± 2.5 (p < 0.0001) and REE on FFM ratio decreased from 31.2 to 28.7 kcal/day/kg (p < 0.001). Preoperative waist circumference (r = −0.3; P < 0.001), blood glucose level (r = −0.37; P < 0.001), and CRP (r = −0.28; P = 0.004) were negatively correlated with EBMIL% 1 year after surgery. Among baseline body composition parameters, only preoperative FM was negatively correlated with %EBMIL (r = −0.23; p = 0.02). One year after surgery FM change was negatively correlated with EBMIL% (r = −0.49; P < 0.001) while FFM/BW ratio was positively correlated with %EBMIL (r = 0.71; P < 0.001). Increase in REE/BW at 1 year was positively correlated with %EBMIL (r = 0.47; p < 0.001). On multivariate analysis, baseline blood glucose level (OR = 1.77; CI 95%: [1.3–2.4]) was the only predictive factor of EBMIL <60% at 1 year.

Conclusion

LRYGB has beneficial effects on clinical, biological parameters, and body composition. Increasing the proportion of FFM on total BW and REE/BW is associated with better results in terms of weight loss. Baseline glucose level may be helpful in identifying poor responders to LRYGBP.

Trial Registration

NCT02820285y (https://clinicaltrials.gov/ct2/show/NCT02820285?term=Characterization+of+Immune+Semaphorin+in+Non-Alcoholic+Fatty+Liver+Disease+and+NASH&rank=1)

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Change history

  • 05 July 2017

    An erratum to this article has been published.

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Author information

Authors and Affiliations

  1. Department of Digestive Surgery, CHU Timone, Marseille, France

    Arnaud Sans & Igor Sielezenef

  2. INSERM UMR-S1076, VRCM, Aix Marseille University, Marseille, France

    Arnaud Sans & Igor Sielezenef

  3. Université Côte d’Azur, LAMHESS, Nice, France

    Laurent Bailly

  4. Département de santé publique, CHU de Nice, Nice, France

    Laurent Bailly

  5. Digestive Unit, Archet 2 Hospital, University Hospital of Nice, 06202, Nice, France

    Rodolphe Anty, Jean Gugenheim, Albert Tran & Antonio Iannelli

  6. Inserm, U1065, Team 8 “Hepatic complications of obesity”, 06204, Nice, France

    Rodolphe Anty, Jean Gugenheim, Albert Tran, Philippe Gual & Antonio Iannelli

  7. University of Nice Sophia-Antipolis, 06107, Nice, France

    Rodolphe Anty, Jean Gugenheim, Albert Tran & Antonio Iannelli

  8. Service de Chirurgie Digestive et Centre de Transplantation Hépatique, Hôpital Archet 2, 151 Route Saint Antoine de Ginestière, BP 3079, Nice, Cedex 3, France

    Antonio Iannelli

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  1. Arnaud Sans
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Corresponding author

Correspondence to Antonio Iannelli.

Ethics declarations

The study was performed according to French legislation regarding Ethics and Human Research and was approved by the local Ethics Committee (Huriet-Serusclat law, DGS2003/0395).

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

The original version of this article was revised: The author names were incorrect.

An erratum to this article is available at https://doi.org/10.1007/s11695-017-2789-0.

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Sans, A., Bailly, L., Anty, R. et al. Baseline Anthropometric and Metabolic Parameters Correlate with Weight Loss in Women 1-Year After Laparoscopic Roux-En-Y Gastric Bypass. OBES SURG 27, 2940–2949 (2017). https://doi.org/10.1007/s11695-017-2720-8

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