1232-P: A Total Weight Loss of 25% Shows Better Predictivity in Evaluating the Efficiency of Bariatric Surgery

Abstract

Objectives: The need for a unified definition of weight loss (WL) after bariatric surgery has recently been highlighted. We aimed to evaluate the reliability of two clinically common WL indications including percentage of total WL (%TWL) and percentage of excess WL (%EWL) through comparing their performances in predicting metabolic syndrome (MetS) remission 1 year after bariatric surgery. Methods: A total of 430 individuals with obesity who underwent bariatric surgery were enrolled. Participants were evaluated for changes in anthropometric parameters, metabolic indexes, MetS components and medications before and 1 year after surgery. MetS was defined using the criteria of the National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans. Results: The prevalence of MetS is 92.3% (397) at baseline. One year after bariatric surgery, 337 individuals (84.9%) were in MetS remission. The multivariate adjusted odds ratios (ORs) were 1.16 (95% confidence interval [CI] 1.10-1.22) for each 1% increase in %TWL for MetS remission and 1.18 (95% CI 1.11-1.25) for each 5% increase in %EWL. This association with MetS remission remained statistically significant for %TWL after additional adjustment for %EWL (P for trend 0.029), and disappeared for %EWL. Receiver operating curve (ROC) analyses showed that the %TWL was more predictive than the %EWL (AUC%TWL vs. AUC %EWL, 0.749 vs. 0.700, p=0.023). The Youden index indicated that the optimal %TWL cut-off point to identify MetS remission was 25%. Conclusions: We recommend that good responders to bariatric surgery should be defined as those exhibiting % TWL ≥25%. Clinical Trial Registration: Evaluation of the effectiveness and safety of metabolic surgery for obesity: a clinical cohort study; Chinese Clinical Trial Registration:ChiCTR1900028513. Disclosure Y. Tu: None. Y. Pan: None. J. Han: None. J. Pan: None. Y. Bao: None. H. Yu: None. Funding National Key Research and Development Project of China (2016YFA0502003); National Natural Science Foundation of China (81670791); Municipal Natural Science Foundation of Shanghai (17ZR1421200); Shanghai Key Clinical Center for Metabolic Disease (2017ZZ01013)