Obesity Surgery最新文献

{"title":"Comparative Performance of Preoperative Diabetes-Remission Scores Following Metabolic Bariatric Surgery: A Retrospective Cohort Study in a Malaysian Population.","authors":"Abdul Rahman Mokhtar, Guo Hou Loo, Farhana Raduan, Nursuhadah Mohamed Yusof, Nik Ritza Kosai","doi":"10.1007/s11695-026-08963-0","DOIUrl":"https://doi.org/10.1007/s11695-026-08963-0","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative scores predict type 2 diabetes mellitus (T2DM) remission after metabolic bariatric surgery (MBS). The original DiaRem score was refined by adding diabetes duration (DiaRem2), and separately by adding duration together with treatment burden and re-weighted penalties (advanced-DiaRem, Ad-DiaRem). Whether these refinements perform better in Asian, sleeve-predominant populations, and across classes of obesity, is unknown.</p><p><strong>Methods: </strong>We retrospectively studied patients with T2DM who underwent laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) at a Malaysian tertiary center between 2018 and 2022. DiaRem, DiaRem2 and Ad-DiaRem were calculated from their originally published scoring algorithms. Remission (complete or partial) followed American Society for Metabolic and Bariatric Surgery criteria. The primary analysis comprised patients with clinic-based glycemic follow-up (n = 204); a pre-specified sensitivity analysis additionally included patients followed by telephone (n = 256). Discrimination was compared using DeLong's test.</p><p><strong>Results: </strong>In the primary cohort (mean age 43.9 years; 72.1% female; 85.3% LSG), 141 patients (69.1%) achieved remission, declining across DiaRem2 groups (85.0%, 66.7%, 19.4%; trend p < 0.001). Ad-DiaRem discriminated best (area under the curve [AUC] 0.852, 95% CI 0.794-0.904), followed by DiaRem (0.807, 0.732-0.872) and DiaRem2 (0.781, 0.707-0.845). Ad-DiaRem outperformed DiaRem2 (p = 0.009) but not DiaRem (p = 0.115), and DiaRem did not differ from DiaRem2 (p = 0.259). In the larger sensitivity cohort, Ad-DiaRem also outperformed DiaRem (p = 0.036). The ordering held across obesity classes and procedures, with no score-by-procedure interaction.</p><p><strong>Conclusion: </strong>In a predominantly Malay, sleeve-predominant cohort, all three scores predicted remission. Adding diabetes duration alone (DiaRem2) did not improve on the original DiaRem, whereas Ad-DiaRem, which also incorporates treatment burden and re-weighted penalties, discriminated best. Because the medication components were reconstructed retrospectively, and because the study was not powered to detect modest differences between scores, these comparisons require confirmation.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Bariatric Surgery on Medication Costs and Disease Burden in Obesity: A Retrospective Cohort Study.","authors":"André Oliveira, Carolina Bulhosa, Pedro Apolónia, Margarida Borges, Eduardo Lima-da-Costa, Hugo Santos-Sousa, Paula Freitas","doi":"10.1007/s11695-026-08894-w","DOIUrl":"10.1007/s11695-026-08894-w","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a highly prevalent chronic disease associated with substantial morbidity, multiple comorbidities, and a significant burden on healthcare systems. Metabolic bariatric surgery (MBS) is effective in achieving weight loss and improving obesity-related comorbidities, potentially reducing pharmacotherapy requirements and overall disease burden. Nevertheless, evidence from Portuguese real-world clinical practice remains limited. Therefore, this study aimed to provide the first Portuguese evaluation of the impact of MBS on pharmacotherapy-related healthcare costs and on the prevalence and burden of obesity-associated comorbidities.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted. Annual pharmacotherapy costs and changes in the prevalence and burden of obesity-associated comorbidities, measured using Years Lived with Disability (YLD), were compared before and 3 years after surgery.</p><p><strong>Results: </strong>Three years after MBS, the mean annual pharmacotherapy cost per patient decreased by €56.11 (p < 0.05). Reductions in medication costs were observed for antihypertensive, lipid-lowering, and antidiabetic therapies (all p < 0.05). The prevalence of obesity-related comorbidities also decreased, particularly hypertension, type 2 diabetes mellitus, dyslipidemia and asthma (all p < 0.05). Correspondingly, the estimated burden of disease decreased, with mean YLD declining from 0.022 before surgery to 0.014 3 years after surgery (p < 0.05).</p><p><strong>Conclusion: </strong>Over 3 years of follow-up, MBS was associated with reductions in medication costs, the prevalence of obesity-related comorbidities, and overall disease burden. These findings highlight the clinical and economic benefits of MBS in the management of obesity and its associated conditions over the medium term.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5222-5232"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Reported Prevalence of Micronutrient Deficiency after Metabolic Bariatric Surgery and Adherence to British Obesity and Metabolic Specialist Society Nutritional Guidelines: A Multicentre Retrospective Cohort Study.","authors":"Guy Holt, Sally Abbott, Charlotte Price, Helen M Parretti, Mary O'Kane, Dimitrios J Pournaras","doi":"10.1007/s11695-026-08960-3","DOIUrl":"https://doi.org/10.1007/s11695-026-08960-3","url":null,"abstract":"<p><strong>Introduction: </strong>Micronutrient deficiencies are common after metabolic bariatric surgery and can lead to serious health complications. The British Obesity and Metabolic Specialist Society recommend routine micronutrient monitoring and supplementation to prevent deficiency, yet real-world adherence to these recommendations is unknown, and multicentre data on postoperative micronutrient status is limited. This study assessed the prevalence of micronutrient deficiencies and adherence to nutritional guidance during the first 12 months after metabolic bariatric surgery in the UK.</p><p><strong>Methods: </strong>A multicentre retrospective cohort study was conducted across 13 bariatric centres across England. Adults undergoing primary metabolic bariatric surgery in 2021 were included. Site-level data were collected on preoperative and 3-, 6- and 12-month postoperative micronutrient levels, clinician blood test requests, and patient-reported adherence to recommended supplementation. The prevalence of each micronutrient deficiency was calculated using patients with available data.</p><p><strong>Results: </strong>Data were available for 669 patients. Early postoperative blood monitoring was inconsistent, with a clinician requesting tests for 33.7% of patients at 3 months, 60.0% at 6 months, and 88.4% at 12 months. Amongst patients tested, low Vitamin D and folate levels were less prevalent at 12 months compared to preoperative values. Low zinc and selenium levels were observed amongst patients who underwent testing during the 12 month follow up period,, with low zinc seen more frequently after sleeve gastrectomy than gastric bypass at all follow-up points - prevalence estimate (95% CI): 16.7% (5.8-39.2) vs. 11.5% (4.0-29.0) at 3 months; 27.6% (14.7-45.7) vs. 10.0% (4.0-23.1) at 6 months; 32.2% (23.2-42.6) vs. 26.0% (18.5-35.1) at 12 months. However, these findings should be interpreted cautiously given the limited availability of trace mineral data and the potential for selective testing. Where recorded, approximately two-thirds of patients self-reported full adherence to supplementation.</p><p><strong>Conclusion: </strong>Among patients with available biochemical testing, micronutrient deficiencies were frequently observed during the first year after MBS. The observed frequency of low zinc and selenium amongst tested patients warrants further prospective investigation to explore clinical implications and to evaluate the earlier and more systematic monitoring of trace minerals after MBS. Inconsistencies in micronutrient blood monitoring and substantial missing postoperative data may suggest that the BOMSS nutritional monitoring guidelines are not being fully implemented in clinical practice across England, limiting the availability of real-world postoperative micronutrient data.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erector Spinae Block in Bariatric Surgery: a Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Giovanna Macanhã Scremin, Pedro Bicudo Bregion, Victor Kenzo Ivano, Gabriel José Souto Maior de França, Julia Bueno de Oliveira Alves, Luísa Zanelatto de Araujo, Pandora Eloa Oliveira Fonseca, Leonardo Halamy Pereira, João Gabriel Romero Braga, Everton Cazzo","doi":"10.1007/s11695-026-08935-4","DOIUrl":"10.1007/s11695-026-08935-4","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a growing global health issue, and bariatric surgery offers effective weight loss outcomes. Postoperative pain management remains a challenge, with multimodal analgesia and regional blocks like the erector spinae plane (ESPB) showing promise. This review aims to evaluate the efficacy of the Erector Spinae Plane Block (ESPB) on key postoperative outcomes in bariatric surgery, specifically its impact on opioid consumption, pain management, and complication rates.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines. In January 2025, we conducted a comprehensive search across PubMed, Embase, and Cochrane databases for studies comparing erector spinae block in bariatric surgery. Data extraction was standardized, focusing on postoperative analgesic consumption, pain control, intraoperative opioid consumption, respiratory complications and PONV. Statistical analysis was performed using RevMan 9.0.0, with random-effects models. Heterogeneity was assessed using Cochran's Q test and I² statistic.</p><p><strong>Results: </strong>The analysis included 9 randomized controlled trials (RCTs) with a total of 553 patients. ESP block significantly reduced total opioid consumption (MD -9.53, 95% CI -15.10 to -3.96, p = 0.0008), pain scores like NRS (MD -1.15, 95% CI -1.76 to -0.55, p = 0.0002). Despite heterogeneity across studies, ESPB was associated with reduced opioid use and better pain control. ESP block was associated with a significant reduction in VAS pain scores during the first 12 h after surgery, although substantial heterogeneity was observed across studies. Using the ESP block significantly reduced the incidence of postoperative nausea and vomiting, with consistent results across studies (I² = 0%). There was no significant difference in the incidence of respiratory complications between the study groups.</p><p><strong>Conclusion: </strong>ESPB is associated with significant reductions in postoperative pain scores and total opioid consumption, while no significant difference in respiratory complications was observed between the groups.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5528-5542"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weighed Down by Paperwork: Identifying Barriers to Metabolic and Bariatric Surgery Evaluation in the United States.","authors":"Rylee Barber, Stephen Moorhead, Kalina Siehl, Ronit Pathak, Mary K Bryant","doi":"10.1007/s11695-026-08888-8","DOIUrl":"10.1007/s11695-026-08888-8","url":null,"abstract":"<p><strong>Background: </strong>Obesity affects over 42% of U.S. adults, yet access to metabolic and bariatric surgery (MBS) remains limited despite its proven efficacy. While use of GLP-1 receptor agonists has risen in the past three years, MBS volume has declined over 25% during the same period. Reported barriers to MBS include long wait times, societal sigma, fear of surgery, and insurance restrictions. This study investigated appointment accessibility and program requirements for patients seeking MBS.</p><p><strong>Methods: </strong>We conducted a secret shopper study of bariatric surgery centers in North Carolina (n=18) and South Carolina (n=17) June - August 2025. Trained callers contacted each program twice, once posing as a patient with Medicaid and once as a patient with private insurance, to request an initial consultation appointment. Data collected included appointment wait times, required documentation, pre-surgical prerequisites, and administrative barriers.</p><p><strong>Results: </strong>Of the 24 centers successfully contacted, all accepted private insurance and 94.3% accepted Medicaid. Median wait time to appointment was 20 days, with no difference by insurance type. On average, programs required 1.7 calls before reaching a scheduler. Most centers (77.1%,n=27) required pre-appointment steps such as an online application, seminar, or PCP referral. Eleven centers could not be reached due to incorrect contact information, and two offered only online intake forms.</p><p><strong>Conclusions: </strong>Rather than insurance-related disparities, we found that administrative barriers such as repeated call attempts, inaccurate contact information, and variable prerequisites were the main obstacles to MBS access. The lack of standardization across programs highlights the need to streamline the evaluation process.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5074-5077"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Index Adopter Characteristics With Peer Surgeon Adoption of Robotic Bariatric Surgery.","authors":"Jayson Marwaha, Matthew Bucala, Akram Irshaid, Oliver A Varban, Johnathan F Finks, Nabeel Obeid, Michael Kia, Amanda Stricklen, Rachel Ross, Erin Charbeneau, Hope T Jackson, Amir A Ghaferi, Arthur M Carlin","doi":"10.1007/s11695-026-08905-w","DOIUrl":"10.1007/s11695-026-08905-w","url":null,"abstract":"<p><strong>Importance: </strong>Robotic surgery adoption in bariatric surgery has expanded rapidly, yet whether early adopter performance influences subsequent peer adoption remains unknown.</p><p><strong>Objective: </strong>To examine the association between index adopter performance characteristics and peer surgeon adoption of robotic bariatric surgery.</p><p><strong>Design, setting, and participants: </strong>Retrospective cohort study using the Michigan Bariatric Surgery Collaborative, a statewide quality improvement registry. Adults undergoing primary laparoscopic or robotic bariatric surgery between 2006 and 2025 were included. Peer surgeons were non-index surgeons at robotic-program sites, each assigned to their earliest robotic site.</p><p><strong>Exposures: </strong>Index adopter characteristics: high surgical volume, low complication rate, fast learning curve, and a composite quality indicator.</p><p><strong>Main outcomes and measures: </strong>Primary outcome was peer surgeon adoption of robotic surgery. Analyses included multivariable logistic regression with sensitivity analyses using propensity score matching, inverse probability weighting, and causal forest methods.</p><p><strong>Results: </strong>The cohort included 87,068 procedures by 121 surgeons at 41 hospitals. Among 106 peer surgeons, 50 (47.2%) adopted robotics (median, 1730 days; IQR, 652-2543). High-volume index adopters were associated with lower peer adoption (adjusted OR, 0.30; 95% CI, 0.09-0.84; P = .03), confirmed by inverse probability weighting (OR, 0.37; P = .04) and causal forest analysis (ATE, - 0.26; P = .02). Results were directionally consistent across all 7 approaches.</p><p><strong>Conclusions and relevance: </strong>High-volume index adopter performance was associated with lower peer adoption, consistent with a crowding-out hypothesis. Promoting technology diffusion may require focusing on equitable robotic resource access rather than peer influence from high-performing early adopters.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5154-5163"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Bariatric Surgery in Kidney Disease: Evidence, Controversies, and Future Needs.","authors":"Ernesto Calderon Martinez, Jonathan Victor Salazar Ore, Patricia Elena Ghattas Hasbun, Bana Khalil, Hrachya Ajamyan, Gabriela Vanessa Flores Monar, Jose Carlos Del Castillo Miranda, Bansi Sutariya","doi":"10.1007/s11695-026-08901-0","DOIUrl":"10.1007/s11695-026-08901-0","url":null,"abstract":"<p><p>Obesity is a growing global epidemic and an established risk factor for chronic kidney disease (CKD). Excess adiposity promotes insulin resistance, hypertension, dyslipidemia, and systemic inflammation, all of which accelerate kidney injury through glomerular hyperfiltration, endothelial dysfunction, and fibrosis. Beyond these indirect mechanisms, obesity can directly cause kidney injury through obesity-related glomerulopathy (ORG), characterized by glomerulomegaly and focal segmental glomerulosclerosis. As the prevalence of both obesity and CKD continues to rise worldwide, strategies that effectively reduce weight and mitigate renal decline have gained increasing clinical relevance. Bariatric surgery, including Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), adjustable gastric banding (AGB), and biliopancreatic diversion, is the most effective long-term intervention for severe obesity. Substantial evidence demonstrates that weight loss after bariatric surgery leads to improvements in blood pressure, glycemic control, lipid profiles, and systemic inflammation, translating into kidney protection. Observational studies and meta-analyses have shown that bariatric surgery reduces albuminuria, slows estimated glomerular filtration rate (eGFR) decline, and lowers the risk of incident CKD and kidney failure. Patients with pre-existing CKD stages 3-4 often experience stabilization or improvement in renal function postoperatively. Furthermore, among patients with end-stage renal disease (ESRD), bariatric surgery-particularly SG-can safely reduce body mass index (BMI), increasing eligibility for kidney transplantation and improving postoperative outcomes. Nevertheless, procedure-specific complications must be considered. RYGB offers the greatest metabolic and renal benefits but carries increased risks of nephrolithiasis, hyperoxaluria, and nutritional deficiencies. SG, a metabolic bariatric procedure characterized by gastric remodelling and favorable neurohormonal adaptations, provides a more favorable renal safety profile in many patients. Despite promising results, long-term randomized controlled trials remain scarce, and kidney-specific endpoints are often secondary outcomes. Future research should compare surgical techniques in CKD populations and integrate pharmacologic therapies such as GLP-1 receptor agonists and SGLT2 inhibitors. Bariatric surgery, when carefully selected and monitored, represents a safe and effective strategy to mitigate obesity-related kidney disease progression.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5055-5073"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography-Derived Gastric Sleeve Volumetry as an Adjunctive Tool for Planning Revisional Single Anastomosis Duodeno-ileal Bypass in Patients with Suboptimal Weight Loss After Sleeve Gastrectomy.","authors":"Ji Young Ye, Seong Min Kim","doi":"10.1007/s11695-026-08917-6","DOIUrl":"10.1007/s11695-026-08917-6","url":null,"abstract":"<p><strong>Introduction: </strong>Single-anastomosis duodeno-ileal bypass (SADI) is an effective revision procedure for patients with suboptimal weight loss after sleeve gastrectomy (SG). However, the clinical value of concomitant revisional SG (ReSG) during revisional SADI remains unclear. This study evaluated the outcomes of revisional SADI with selective ReSG guided by preoperative computed tomography (CT) volumetry.</p><p><strong>Methods: </strong>This single-center retrospective study analyzed prospectively collected data of patients who underwent revisional SADI following SG between 2019 and 2023. Preoperative CT volumetry was used to measure gastric tube, antral, and total sleeve volumes. ReSG was selectively performed based on CT-derived volumetric findings and intraoperative assessments. Perioperative outcomes, complications, and weight-loss parameters were reviewed.</p><p><strong>Results: </strong>Twenty-three female patients underwent revisional SADI and completed at least 12 months of follow-up. The mean interval between primary SG and revision was 41.3 ± 21.6 months. ReSG was performed in 20 patients, whereas three underwent SADI only. The mean follow-up duration after revision was 21.4 ± 9.0 months. The mean percent total weight loss (%TWL) after revisional SADI was 40.2 ± 5.4%, an additional 27.4 ± 8.8% compared with SG only. The postoperative complications were manageable, including one thromboembolic event and two malnutrition cases, one of which required reversal surgery.</p><p><strong>Conclusion: </strong>Revisional SADI was associated with substantial additional weight reduction in patients with suboptimal weight loss after SG. Concurrent ReSG may be considered in select patients with enlarged gastric sleeve segments. Preoperative CT sleeve volumetry may provide adjunctive surgical planning support, with approximately 110 ml serving as the exploratory reference point.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5349-5357"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Magnetic Resonance Imaging-Derived Adiposity Profiling and Cardiometabolic Remodeling After Metabolic and Bariatric Surgery.","authors":"Chin-Feng Hsuan, Yu-Lan Chang, Chung-Yi Yang, Jian-Han Chen, Sin-Rong Huang, Shih-Hua Huang, Chen-Hui Hung, Thung-Lip Lee, Jou-Wei Lin","doi":"10.1007/s11695-026-08942-5","DOIUrl":"10.1007/s11695-026-08942-5","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic remodeling after metabolic and bariatric surgery is heterogeneous and may not be fully characterized by clinical measures. This exploratory pilot study examined whether abdominal magnetic resonance imaging (MRI)-derived adiposity profiles, combined with clinical and echocardiographic data, could identify preoperative patterns associated with 12-month cardiometabolic remodeling after laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>This prospective study included 40 adults with severe obesity who underwent LSG. Baseline clinical characteristics, MRI-derived subcutaneous adipose tissue (SAT), visceral adipose tissue, liver fat fraction, and transthoracic echocardiographic parameters were evaluated in relation to 12-month changes in body weight (BW), glycated hemoglobin (A1C), mean blood pressure (mean BP), and left ventricular mass index (LVMI). Elastic net regression with 1,000 bootstrap resamples was used to identify stable exploratory signals.</p><p><strong>Results: </strong>At 12 months, participants achieved a BMI reduction of 14.78 ± 4.52 kg/m², corresponding to 90.01 ± 24.06% excess BMI loss, with significant improvements in A1C, mean BP, and LVMI (all p < 0.001). Higher baseline BW and A1C were associated with greater weight loss and glycemic improvement, respectively. Cardiovascular remodeling showed distinct patterns: higher baseline BP and greater abdominal SAT were associated with greater BP reduction, whereas greater baseline LVMI and lower estimated filling pressure were associated with more favorable cardiac reverse remodeling. Removing MRI variables reduced model performance for mean BP reduction and LVMI regression but had little effect on weight loss or glycemic improvement.</p><p><strong>Conclusions: </strong>MRI-derived adiposity measures may add selective information for cardiovascular remodeling after LSG, but require validation in larger independent cohorts.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5447-5458"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Anxiety and/or Depression Symptoms with Gastrointestinal Complaints Five Years after Metabolic and Bariatric Surgery - a Cross-sectional Study.","authors":"Nadia Botros, Yonta G R van der Burgh, Laura N Deden, Elske M van den Berg, Agnes A M Berendsen, Eric J Hazebroek","doi":"10.1007/s11695-026-08899-5","DOIUrl":"10.1007/s11695-026-08899-5","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal (GI) symptoms are common following metabolic and bariatric surgery (MBS) and can significantly impair quality of life. Previous research indicates that anxiety and depressive symptoms could be associated with GI complaints. This study aims to investigate the association between anxiety and/or depressive symptoms and GI complaints five years after MBS.</p><p><strong>Methods: </strong>In this cross-sectional study 220 participants who underwent MBS were included. Self-reported anxiety and/or depressive symptoms were measured with the Hospital Anxiety and Depression Scale and GI complaints with the Gastrointestinal Symptom Rating Scale. Differences in GI complaint scores between participants with no, mild or severe anxiety and/or depression symptoms were assessed using Kruskal-Wallis and post-hoc tests. Furthermore, the association between anxiety and/or depressive symptom categories and moderately-severe to severe GI complaints (any GRSR item score ≥ 5 out of 7) was assessed by modified Cox regression.</p><p><strong>Results: </strong>Participants were on average 50 ± 11 years of age five years post-MBS, mostly female (81%) and predominantly underwent RYGB (87%). 28% reported anxiety and/or depressive symptoms, of which 15% mild and 13% severe. 42% of participants reported moderately-severe to severe GI complaints, of which 20% was severe. Participants with severe anxiety and/or depressive symptoms had significantly higher total and domain GI complaint scores (abdominal pain, reflux syndrome, constipation syndrome) than participants without these symptoms (p<.001). Similar trends were found in participants with mild anxiety and/or depressive symptoms (total p<.001, reflux syndrome p=.048, constipation syndrome p=.005), the association with abdominal pain was on the borderline of significance (p=.05). Participants with mild or severe anxiety and/or depressive symptoms respectively had a 1.75 (95%CI 0.98-3.11; not statistically significant) and 2.55 (95%CI 1.45-4.47) times higher risk (BMI and sleep adjusted prevalence ratio's) of experiencing moderately-severe to severe GI complaints compared to those without.</p><p><strong>Conclusion: </strong>Participants 5-years post-MBS with mild to severe self-reported anxiety and/or depressive symptoms are at a higher risk of reporting more severe GI complaints. These findings underscore the need to assess and refer anxiety and/or depressive symptoms when counselling patients after MBS with GI complaints.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5307-5315"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}