[Factors related with weight loss in a cohort of obese patients after gastric bypass].

Abstract:

INTRODUCTION:Obesity is held as the 21(st) Century epidemics. Multidisciplinary medical management has been insufficient and surgical techniques are more frequently used. Gastric bypass is considered the gold standard in bariatric surgery; however, some patients report low rates of weight loss, which leads to thinking about other conditioning factors. OBJECTIVE:To establish the factors associated to weight loss in a cohort of obese patients submitted to gastric bypass. METHODS:Analytical retrospective study. The study variable was weight loss, expressed as the percentage of excess body mass index lost (%EBMIL). A linear regression model of mixed effects was performed as well as a COX model of proportional risks. RESULTS:166 patients aged 19-69 years, most of them women (74.7%), were studied. The average baseline body mass index (BMI) was 46.9 ± 6.8 kg/m(2) and 46.3 ± 7.7 kg/m(2) for males and females, respectively. The multivariate analysis showed that for each 10.0 kg/m(2) in excess at the time of surgery, the PBMIEL decreased by 9.8% and that inadequate daily caloric intake decreased the PBMIEL by 4.0%. For each 10.0 kg/m(2) of baseline BMI, there was a 57.8% decrease in the likelihood of achieving a 50% weight loss. CONCLUSIONS:The patients with lower weight excess according to their BMI have a better response to bariatric surgery in terms of PBMIEL. :Introducción: La obesidad es catalogada como la epidemia del siglo XXI. El tratamiento médico multidisciplinario no ha sido suficiente y las técnicas quirúrgicas son empleadas con mayor frecuencia. El bypass gástrico es considerado el gold standard de la cirugía bariátrica, sin embargo, algunos pacientes reportan bajas tasas de pérdida de peso, lo que hace pensar en otros factores condicionantes. Objetivo: Establecer los factores asociados con la pérdida de peso, en una cohorte de pacientes obesos sometidos a bypass gástrico. Métodos: Estudio analítico retrospectivo. La variable respuesta fue la pérdida de peso, expresada en porcentaje del exceso de índice de masa corporal perdido (PEIMCP). Se realizó un modelo de regresión lineal de efectos mixtos y un modelo de riesgos proporcionales de COX. Resultados: Se estudiaron 166 pacientes entre 19 y 69 años, la mayoría mujeres (74,7%). Los hombres presentaron un índice de masa corporal (IMC) inicial promedio de 46,9 ± 6,8 kg/m2 y las mujeres de 46,3 ± 7,7 kg/m2. El análisis multivariado mostró que por cada 10,0 kg/m2 de mas al momento de la cirugía, disminuyó el PEIMCP en un 9,8% y un inadecuado consumo calórico diario disminuyó en un 4,0% el PEIMCP. Por cada 10,0 kg/m2 de IMC inicial, hubo una disminución del 57,8% en la probabilidad de lograr una pérdida de peso del 50%. Conclusiones: Los pacientes con menor exceso de peso según su índice IMC responden mejor a la cirugía bariátrica en términos del PEIMCP.

journal_name

Nutr Hosp

journal_title

Nutricion hospitalaria

authors

Giraldo Villa A,Serna López ÁM,Mustiola Calleja KG,López Gómez LM,Donado Gómez J,Toro Escobar JM

doi

10.3305/nh.2013.28.3.6176

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

623-30

issue

3

eissn

0212-1611

issn

1699-5198

journal_volume

28

pub_type

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