Early-phase insulin hypersecretion associated with weight loss outcome after LSG: a prospective cohort study in Asian patients with BMI >= 28 kg/m(2)

作者全名："Guo, Lu; Luo, Wenjin; Tan, Tao; Gong, Faping; Liu, Xiurong; Rao, Siqi; Lian, Fei; Liu, Jia; Chen, Xiangjun; Li, Guochuan; Yang, Zhiyou; Mei, Mei; Hu, Jinbo; Li, Qifu; Wang, Zhihong; Zhang, Jun; Zeng, Menghua; Gong, Lilin"

作者地址："[Guo, Lu; Luo, Wenjin; Liu, Xiurong; Lian, Fei; Chen, Xiangjun; Mei, Mei; Hu, Jinbo; Li, Qifu; Wang, Zhihong; Gong, Lilin] Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing, Peoples R China; [Guo, Lu] Chongqing Med Univ, Affiliated Hosp 1, Lab Endocrine, Chongqing, Peoples R China; [Guo, Lu] Chongqing Med Univ, Affiliated Hosp 1, Lab Lipid & Glucose Metab, Chongqing, Peoples R China; [Tan, Tao; Gong, Faping; Rao, Siqi; Liu, Jia; Li, Guochuan; Yang, Zhiyou; Zhang, Jun; Zeng, Menghua] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing, Peoples R China"

通信作者："Gong, LL (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing, Peoples R China.; Zeng, MH (通讯作者)，Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, 1 Youyi St, Chongqing 400016, Peoples R China."

来源：SURGERY FOR OBESITY AND RELATED DISEASES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000996174600008

JCR分区：Q1

影响因子：3.1

年份：2022

卷号：18

期号：10

开始页：1209

结束页：1217

文献类型：Article; Proceedings Paper

关键词：Obesity; Laparoscopic sleeve gastrectomy; Weight loss; Hyperinsulinemia

摘要："Background: Obesity has become a global problem that poses a serious threat to human health. Laparoscopic sleeve gastrectomy (LSG) is an effective long-term treatment. However, the weight loss of some patients after LSG is still insufficient. It is necessary to investigate the factors associated with inadequate weight loss after LSG. Objective: The objective of this study was to explore whether preoperative insulin secretion could be associated with weight loss after LSG in patients with obesity. Setting: This is a single-center prospective cohort study conducted in a university hospital. Methods: Patients from a prospective database who underwent LSG were analyzed. All 178 participants underwent a 75-g oral glucose tolerance test (OGTT) to assess preoperative insulin and c-peptide secretion before LSG. The areas under the curve (AUCs) for glucose, insulin, and c-peptide were determined in the OGTT. The percentage of excess weight loss (%EWL) and the percentage of total weight loss (%TWL) were used to estimate the effect of weight loss after LSG. Regression models were used to assess the correlation between preoperative insulin and c-peptide secretion with % EWL >= 75% and TWL >= 35% at 12 months after LSG. Results: TheAUCs of insulin and c-peptide were significantly lower in the%EWL >= 75% and%TWL >= 35% groups at 0-30 minutes, 0-60 minutes, and 0-120 minutes during the OGTT. At 30, 60, and 120 minutes during the OGTT, c-peptide levels were significantly lower in the%EWL >= 75% group and% TWL >= 35% group. The preoperative c-peptide level at 30 minutes during the OGTT (C-30) was significantly negatively correlated with %EWL (beta = 2.37, P < .001) and %TWL (beta = 2.28, P = .011). Univariate logistic regression analysis showed that preoperative C-30 was associated with %EWL >= 75% and %TWL >= 35% after LSG. According to multiple logistic regression analysis, patients with a low preoperative C-30 had an 8-fold higher %TWL >= 35% after LSG than those with a high C-30 (odds ratio: 8.41 [95% confidence interval: 1.46-48.58], P = .017). Similarly, patients with a low preoperative C-30 had a 7-fold higher EWL% >= 75% after LSG than patients with a high C-30 (odds ratio: 7.25 [95% confidence interval: 1.11-47.50], P = .039). Conclusions: The rate of weight loss after LSG is low among patients with preoperative hyperinsulinemia. The preoperative c-peptide level at 30 minutes during the OGTT is associated with weight loss after LSG. (c) 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved."

基金机构："National Natural Science Foundation of China [81800757, 81800731]; Bethune Merck Diabetes Research Foundation [G2018030]; Science and Technology Research Program of Chongqing Municipal Education Commission [KJQN201900409]"

基金资助正文："This work was supported by the National Natural Science Foundation of China (81800757, 81800731); the Bethune Merck Diabetes Research Foundation (G2018030); the Science and Technology Research Program of Chongqing Municipal Education Commission (KJQN201900409)."