Presurgery health influences outcomes following vertical sleeve gastrectomy in adolescents

Author:

Swertfeger Debi1ORCID,Kim Ahlee123,Sexmith Hannah1,Moreno‐Fernandez Maria E.45,Davidson W. Sean6,Helmrath Michael7,Jenkins Todd58,Okura Tsuyoshi1,Geh Esmond1,Xanthakos Stavra A.45,Szabo Sara9,Nakamura Takahisa1,Divanovic Senad41011,Shah Amy Sanghavi14

Affiliation:

1. Division of Endocrinology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

2. Division of Endocrinology, Department of Pediatrics Children’s Hospital Los Angeles Los Angeles California USA

3. Keck School of Medicine of University of Southern California Los Angeles California USA

4. Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA

5. Division of Gastroenterology Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

6. Center for Lipid and Arteriosclerosis Science, Department of Pathology and Laboratory Medicine University of Cincinnati Cincinnati Ohio USA

7. Department of Surgery Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

8. Department of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

9. Division of Pathology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

10. Division of Immunobiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

11. Center for Inflammation and Tolerance, Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA

Abstract

AbstractObjectiveWeight loss following vertical sleeve gastrectomy (VSG) in youth can range from 10% to 50%. We examined whether there are differences in demographic or metabolic parameters before VSG in youth who achieve above‐average weight loss (AAWL) versus below‐average weight loss (BAWL) at 1 year post VSG and if youth with BAWL still achieve metabolic health improvements at 1 year post VSG.MethodsDemographic, anthropometric, and clinical lab data were collected before VSG and at 1, 3, 6, and 12 months after VSG.ResultsForty‐three youth with a mean age of 16.9 (SD 1.7) years before VSG were studied; 70% were female, 19% non‐Hispanic Black, 58% non‐Hispanic White, and 23% mixed/other race. Mean baseline BMI was 51.1 (SD 10.5) kg/m2. Average weight loss was 25.8%. The AAWL group lost 18.6 kg/m2 (35.3%) versus the BAWL group, who lost 8.8 kg/m2 (17.5%). BMI, age, race, sex, and socioeconomic status at baseline were similar between AAWL and BAWL groups; however, the BAWL group had a higher frequency of pre‐VSG dysglycemia, steatotic liver disease, and dyslipidemia. At 1 year post VSG, fewer youth in the BAWL group achieved ideal health parameters, and they had less resolution of comorbidities.ConclusionsThe presence of comorbidities before VSG is associated with less weight loss and reduced resolution of metabolic conditions at 1 year post VSG.

Funder

Cincinnati Children's Hospital Medical Center

National Institute of Diabetes and Digestive and Kidney Diseases

Japan Society for the Promotion of Science

U.S. Department of Defense

National Heart, Lung, and Blood Institute

Publisher

Wiley

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