Cortisol secretion autonomy associated with weight loss outcome after laparoscopic sleeve gastrectomy: a prospective cohort study in Asian patients.

IF 3.3 4区医学 Q1 Medicine

European review for medical and pharmacological sciences Pub Date : 2024-06-01 DOI:10.26355/eurrev_202406_36377

L Zhang, F-P Gong, X-R Liu, X-J Chen, F Lian, L Guo, T Tan, Y Zhang, Q-N Zhen, M Mei, J-B Hu, Q-F Li, Z-H Wang, J Zhang, M-H Zeng, L-L Gong

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引用次数: 0

Abstract

Objective: Laparoscopic sleeve gastrectomy (LSG) is a widely recognized effective bariatric surgery. However, variable weight loss outcomes post-surgery remained a clinical challenge. Currently, there is no established consensus on the factors influencing weight loss failure following LSG. This study aimed to explore the association between preoperative cortisol secretion autonomy and postoperative weight loss in obese patients undergoing LSG.

Patients and methods: A cohort of 181 patients with simple obesity (BMI ≥ 28 kg/m2) who underwent LSG and were followed up for one year was analyzed. Weight loss was measured by the percentage of excess weight loss (%EWL), and cortisol secretion autonomy was evaluated using a 1 mg dexamethasone suppression test (DST). Regression models were used to analyze the correlation between preoperative 1 mg DST results and %EWL one year after laparoscopic sleeve gastrectomy (LSG).

Results: Cortisol secretion autonomy was significantly lower in the %EWL ≥ 75% group and higher in the %EWL < 75% group, showing a negative correlation with %EWL (R = -0.336, p = 0.001). Logistic regression analysis indicated that high cortisol secretion autonomy was significantly correlated with %EWL < 75% after LSG. The likelihood of %EWL being < 75% was 10.47 times greater in patients with high cortisol secretion autonomy compared to those with low cortisol secretion autonomy (odds ratio 10.472, confidence interval: 1.660-66.048, p = 0.012).

Conclusions: Cortisol secretion autonomy emerges as an independent predictor of weight loss outcomes in Asian patients undergoing LSG. This finding suggests the potential for cortisol secretion autonomy to inform preoperative assessments and personalized treatment strategies in bariatric surgery.

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皮质醇分泌自主性与腹腔镜袖带胃切除术后的减肥效果相关：一项针对亚洲患者的前瞻性队列研究。

目的：腹腔镜袖带胃切除术（LSG）是公认有效的减肥手术。然而，术后不同的减肥效果仍是一个临床难题。目前，关于影响 LSG 术后减肥失败的因素尚未达成共识。本研究旨在探讨接受LSG手术的肥胖患者术前皮质醇分泌自主性与术后体重减轻之间的关系：研究分析了181名接受LSG手术并随访一年的单纯性肥胖（体重指数≥ 28 kg/m2）患者。体重减轻以超重百分比（%EWL）来衡量，皮质醇分泌自主性以 1 毫克地塞米松抑制试验（DST）来评估。使用回归模型分析术前 1 毫克 DST 结果与腹腔镜袖带胃切除术（LSG）一年后超重百分比（%EWL）之间的相关性：结果：皮质醇分泌自主性在%EWL≥75%组明显较低，而在%EWL<75%组较高，与%EWL呈负相关（R = -0.336，p = 0.001）。逻辑回归分析表明，皮质醇分泌自主性高与 LSG 后的 %EWL < 75% 显著相关。与皮质醇分泌自主性低的患者相比，皮质醇分泌自主性高的患者出现 %EWL < 75% 的可能性要高出 10.47 倍（几率比 10.472，置信区间：1.660-66.048，p = 0.012）：皮质醇分泌自主性是预测接受整容手术的亚洲患者减肥效果的独立指标。这一发现表明，皮质醇分泌自主性有可能为减肥手术的术前评估和个性化治疗策略提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European review for medical and pharmacological sciences 医学-药学

CiteScore

5.30

自引率

6.10%

发文量

906

审稿时长

2-4 weeks

期刊介绍： European Review for Medical and Pharmacological Sciences, a fortnightly journal, acts as an information exchange tool on several aspects of medical and pharmacological sciences. It publishes reviews, original articles, and results from original research. The purposes of the Journal are to encourage interdisciplinary discussions and to contribute to the advancement of medicine. European Review for Medical and Pharmacological Sciences includes: -Editorials- Reviews- Original articles- Trials- Brief communications- Case reports (only if of particular interest and accompanied by a short review)