Abstract
Background and Aims: Identification of preoperative predictors of weight loss after Roux-en-Y gastric bypass surgery may lead to better clinical management. The purpose of this study was to identify whether any clinical variables were different in patients with the best versus worst weight loss outcomes at 24 months following RYGB.
Methods: Patients who were recruited were enrolled in the Bariatric Surgery Program of the Geisinger Clinic Center for Nutrition and Weight Management. Only Caucasian patients with a BMI greater than 35 kg/m2 who underwent primary Roux-en-Y gastric bypass were included in the analysis. An analysis of available data on more than 200 clinical variables related to medication use, co-morbidities, and baseline laboratory and survey data was performed to determine whether any differences present between the 150 patients who lost the most weight and the 150 patients who lost the least. Chi-square tests and Wilcoxon Rank sum tests were used after a Bonferroni correction.
Results: A total of 1001 patients (80% female) with a mean age of 46.5 years and a mean initial BMI of 50.2 mg/kg were studied. The diagnosis of diabetes was almost twice as frequent in patients who lost the least weight (p <0.0001). Initial weight, BMI, excess body weight, and waist circumference were also statistically higher in patients who lost the least weight (p <0.0001), although the differences were likely not clinically significant in patients of this BMI range. Post-operatively, the percentage of patients with pre-operative diabetes that had a hemoglobin A1c over 6.5% was approximately 2-fold higher in the group who lost the least weight.
Conclusions: A pre-operative diagnosis of diabetes and post-operative elevation of hemoglobin A1C levels were more prevalent in those patients with the poorest weight loss outcomes following Roux-en-Y gastric bypass surgery.
- Received May 27, 2010.
- Accepted May 27, 2010.
