Analysis of correlation between BMI and TWL% outcome following metabolic and bariatric surgery: a retrospective study using restricted cubic spline

Autor: Guanyang Chen, Zhehong Li, Liang Wang, Qiqige Wuyun, Qing Sang, Jing Wang, Zheng Wang, Chenxu Tian, Chengyuan Yu, Buhe Amin, Nengwei Zhang, Qing Fan
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Surgery, Vol 24, Iss 1, Pp 1-8 (2024)
Druh dokumentu: article
ISSN: 1471-2482
DOI: 10.1186/s12893-024-02455-7
Popis: Abstract Objective This study aimed to examine the correlation between preoperative body mass index (BMI) and adequate percentage of total weight loss (TWL%) outcome and present evidence of tiered treatment for patients with obesity in different preoperative BMI. Methods We included patients with complete follow-up data who underwent metabolic and bariatric surgery (BMS). We termed optimal clinical response as TWL% >20% at one year following MBS. To investigate dose-response association between preoperative BMI and optimal clinical response, preoperative BMI was analyzed in three ways: (1) as quartiles; (2) per 2.5 kg/m2 units (3) using RCS, with 3 knots as recommended. Results A total of 291 patients with obesity were included in our study. The corresponding quartile odds ratios associated with optimal clinical response and adjusted for potential confounders were 1.00 (reference), 1.434 [95% confidence interval (95%CI) = 0.589–3.495], 4.926 (95%CI = 1.538–15.772), and 2.084 (95%CI = 0.941–1.005), respectively. RCS analysis showed a non-linear inverted U-shaped association between preoperative BMI and optimal clinical response (Nonlinear P = 0.009). In spline analysis, when preoperative BMI was no less than 42.9 kg/m2, the possibility of optimal clinical response raised as preoperative BMI increased. When preoperative BMI was greater than 42.9 kg/m2, the possibility of optimal clinical response had a tendency to decline as preoperative BMI increased. Conclusion Our research indicated the non-linear inverted U-shaped correlation between preoperative BMI and adequate weight loss. Setting a preoperative BMI threshold of 42.9 is critical to predicting optimal clinical outcomes.
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