Obesity Surgery最新文献

{"title":"Comparative Outcomes of Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass in Adults with Severe Obesity: A Systematic Review and Meta-Analysis.","authors":"Ali Altwaheih, Feras W Atieh, Ibrahim Abdel-Jaleel, Omar Abdelghani, Mohammad G Alomari, Sondos Jallad, Nadine Abed, Hashem Altabbaa","doi":"10.1007/s11695-026-08934-5","DOIUrl":"10.1007/s11695-026-08934-5","url":null,"abstract":"<p><p>Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is increasingly used for severe obesity, but its comparative effectiveness versus Roux-en-Y gastric bypass (RYGB) remains uncertain. This systematic review and meta-analysis included 12 comparative studies (3,317 patients) identified through searches of major databases to April 2026. Random-effects meta-analyses suggested a potential weight-loss benefit with SADI-S compared with RYGB at selected follow-up points, while no clear differences were observed in remission of type 2 diabetes, hypertension, or dyslipidemia, or in HbA1c reduction. No clear differences were observed in operative outcomes or early complications, while the findings suggested potential reductions in reoperations and selected late surgical complications with SADI-S; a nonsignificant trend toward greater calcium deficiency was also observed. Evidence certainty was predominantly low or very low because of methodological limitations and heterogeneity. Comparative mortality could not be assessed because no included study provided mortality data suitable for pooling, highlighting the need for high-quality long-term randomized studies.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5510-5527"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977582","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":"Physical Exercise in Obesity and Metabolic Bariatric Surgery: The First Latin American Consensus.","authors":"Andrea Herrera-Santelices, Cristina Aquino, Leonardo Aburto Borzone, Santiago Alderete, Omar Andrade-Mayorga, Francesca Balocchi Iturra, María Laura Bruno, Jorge Cancino-López, Johnattan Cano-Montoya, Karen Castañeda Lavín, Francisco Cerda-Vásquez, Patricia da Costa Tarragó, Danillo da Silva Alves, Alexanderson Fernández Paniura, Javier Santiago Franco Casillas, Nicolas Gonzalez, Martín Elias Ivancovich, María Fernanda Leonardi, Sandra Mahecha-Matsudo, Emilian Rejane Marcon, Camila Mautner Molina, Nelson Nardo Junior, Carolina Núñez-Vergara, Mariela Olivares Gálvez, Cecilia Betsabe Penutto, Johanna Pino Zúniga, Israel Podesta-Donoso, Christian Ramírez Oróstica, Eliana Rojas Sanchez, María Victoria Sáez Del Rio, Washington Valverde Ampai, Alexandre Vieira Gadducci, Greice Westphal-Nardo, Erika J Troncoso-Ortiz","doi":"10.1007/s11695-026-08897-7","DOIUrl":"10.1007/s11695-026-08897-7","url":null,"abstract":"<p><p>Physical activity and exercise are key components in obesity management and in the perioperative care of metabolic bariatric surgery (MBS) patients. However, in Latin America, clinical practice remains heterogeneous and lacks regionally adapted, evidence-informed recommendations.</p><p><strong>Aim: </strong>To develop clinical exercise recommendations for adults with obesity and for patients undergoing MBS, based on expert consensus informed by current evidence.</p><p><strong>Methods: </strong>A three-round modified Delphi process was conducted with Latin American experts in exercise science, obesity, and MBS. Recommendations covered assessment, exercise prescription, perioperative management, long-term follow-up, and virtual care. Experts were instructed to prioritize recent evidence published within the previous five years, and recommendations were formulated using the PICO framework as a pragmatic guide. Agreement was assessed on a 5-point Likert scale. Positive consensus required ≥ 70% agreement, ≤ 15% disagreement, standard deviation ≤ 1.0, and interquartile range ≤ 1.0. Response stability was evaluated using the coefficient of variation (≤ 20%).</p><p><strong>Results: </strong>Thirty-one experts participated. Of 121 proposed recommendations, 106 reached positive consensus: 45 for obesity management and 61 for MBS. These recommendations provide guidance on individualized assessment, exercise prescription, perioperative strategies, long-term physical activity maintenance, and virtual care. No recommendations reached negative consensus.</p><p><strong>Conclusions: </strong>This consensus provides the first region-specific, clinically oriented exercise recommendations for obesity and MBS in Latin America. It supports multidisciplinary practice, promotes standardization of care, and provides a framework for future updates and implementation studies.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5233-5254"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796150","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":"Development of an Explainable Machine Learning Model for Predicting Reflux Esophagitis Among Candidates for Metabolic Bariatric Surgery.","authors":"Zhenguang Mo, Yuzhou Yang, Yu Liu, Bingsheng Guan, Lvjia Cheng, Lina Wu, Wenfu Ding, Ran Wei, Xiran Luo, Zeyu Xiao, Shifang Huang, Zhiguang Gao, Jingge Yang","doi":"10.1007/s11695-026-08943-4","DOIUrl":"10.1007/s11695-026-08943-4","url":null,"abstract":"<p><strong>Background: </strong>Reflux esophagitis (RE) is a common gastroesophageal disorder among candidates for metabolic bariatric surgery (MBS). This study aimed to develop and internally validate an explainable machine learning (ML) model for predicting preoperative RE risk among patients undergoing MBS.</p><p><strong>Methods: </strong>This retrospective study included 1,068 MBS candidates who were randomly divided into training and internal test cohorts (7:3). Feature selection was performed using correlation analysis, multicollinearity assessment, LASSO regression, and the Boruta algorithm. Six ML algorithms were developed and evaluated based on AUC, calibration, and classification metrics. SHAP analysis was used for model interpretation, and an online risk assessment tool was developed.</p><p><strong>Results: </strong>Among the 1,068 patients, 280 (26.2%) were diagnosed with RE. Six predictors were ultimately selected, including Sex, Hp, BMI, TG, HGB, and HC. Among the six ML algorithms, the XGB model demonstrated the best overall predictive performance, achieving AUC values of 0.881 and 0.825 in the training and internal test cohorts, respectively. SHAP analysis identified TG, BMI, Hp, HC, HGB, and Sex as the major contributors to model predictions. The online tool developed based on the final XGB model enabled individualized RE risk prediction.</p><p><strong>Conclusions: </strong>We developed an explainable XGB model based on routinely available preoperative clinical variables to predict RE risk among MBS candidates. The model demonstrated acceptable predictive performance and interpretability and may assist in preoperative RE risk stratification and perioperative risk management. However, external validation in independent cohorts is required to further evaluate its robustness and generalizability.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5078-5092"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983388","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":"Effects of supervised exercise immediately after bariatric surgery: results from the EFIBAR randomized trial.","authors":"Elena Martínez-Rosales, Alba Hernández-Martínez, Laura López-Sánchez, María José Torrente-Sánchez, Alba Esteban-Simón, Emilio Villa-González, Yaira Barranco-Ruiz, Manuel A Rodríguez-Pérez, Manuel Alcaraz-Ibáñez, Carlos Gómez-Navarro, Jesús Aceituno, Reúl Reyes-Parrilla, José Antonio Aparicio-Gómez, Lorena Carmona-Rodríguez, Pablo Soriano-Maldonado, Sonia Martínez-Forte, Ana María Fernández-Alonso, Manuel Ferrer-Márquez, Alberto Soriano-Maldonado, Enrique G Artero","doi":"10.1007/s11695-026-08915-8","DOIUrl":"10.1007/s11695-026-08915-8","url":null,"abstract":"<p><strong>Introduction: </strong>Bariatric surgery is the most effective treatment for severe obesity. We evaluated whether a 16-week supervised exercise program initiated immediately post-surgery improves weight loss, body composition, cardiometabolic health, inflammation, and physical fitness compared with usual care.</p><p><strong>Methods: </strong>In this randomized clinical trial, 80 participants undergoing bariatric surgery were assessed before surgery, 4- and 12-month post-surgery. The intervention consisted of 16 weeks of individually supervised concurrent exercise training initiated ~ 10 days post-surgery, with three 60-min sessions/week including progressive resistance training (50-75% of one-repetition maximum) and aerobic training (65-85% heart rate reserve). Adherence was monitored throughout the intervention. The main outcome was percent of total weight loss (%TWL).</p><p><strong>Results: </strong>No significant differences between groups were observed for the primary outcome. At 4 months, %TWL was 24.9% in the exercise group and 23.4% in the control group; corresponding values at 12 months were 37.0% and 37.2%, respectively. Compared with usual care, the exercise group showed greater reductions in systolic blood pressure (- 6.5 mmHg; 95% CI, - 12.7 to - 0.2; p = 0.040) and glycated hemoglobin (- 0.3%; 95% CI, - 0.5 to - 0.1; p = 0.018) at 4 months. These differences were not maintained at 12 months. No significant between-group differences were observed in body composition, inflammatory markers, or physical fitness outcomes at any timepoint.</p><p><strong>Conclusion: </strong>A 16-week supervised concurrent exercise program initiated ~ 10 days after bariatric surgery did not improve weight loss compared with usual care. Although short-term improvements in systolic blood pressure and glycated hemoglobin were observed, these were not sustained at 12 months.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5325-5338"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892136","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":"Cross-Sectional Differences in BMI, Sarcopenia Risk, and Quality of Life During the First Postoperative Year Following Sleeve Gastrectomy: An Exploratory Study.","authors":"Kim Ngan Phung, Brett Crossland","doi":"10.1007/s11695-026-08912-x","DOIUrl":"10.1007/s11695-026-08912-x","url":null,"abstract":"<p><strong>Introduction: </strong>Sleeve gastrectomy (SG) effectively reduces body mass index (BMI); however, rapid postoperative weight loss may result in skeletal muscle loss and transiently impair health-related quality of life (QoL). Concurrent data on these three outcomes across the first postoperative year remain limited, particularly in the southern United States.</p><p><strong>Methods: </strong>This exploratory cross-sectional study enrolled 55 patients (aged 30-50 years; preoperative BMI 30-45 kg/m²) who underwent SG at healthcare facilities across Texas and were stratified by postoperative interval: 3-6, 6-9, and 9-12 months. Sarcopenia risk was assessed using the SARC-F questionnaire (threshold ≥ 4), and QoL was measured using the EQ-5D-5 L with the United States value set. Nonparametric methods included the Kruskal-Wallis H test with Dunn post-hoc correction.</p><p><strong>Results: </strong>Median BMI decreased significantly from 40.8 to 29.2 kg/m² (Wilcoxon Z = - 6.45, r = .87, p < .001). Sarcopenia risk was markedly lower in patients assessed at 9-12 months (35.3%) than in those assessed at 3-6 months (90.5%) (p < .001). The QoL index was higher in the 9-12-month group (0.90) than in the 3-6-month group (0.84) (p < .001). Moderate to extreme pain and discomfort was reported by 38.1% of patients in the 3-6-month group versus 0.0% in the 9-12-month group. Middle-aged patients demonstrated significantly higher sarcopenia burden (r = .591) and lower QoL (r = .446) compared with early adults.</p><p><strong>Conclusion: </strong>BMI, sarcopenia risk, and QoL differed favorably across groups assessed later in the first postoperative year. The high sarcopenia risk observed in patients early in the postoperative course supports routine SARC-F screening from 3 months postoperatively and phase-specific rehabilitation. Future longitudinal studies with objective body composition assessments are warranted.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5316-5324"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808992","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":"Eating Compulsion Behavior Assessment in Patients Before and After Bariatric Surgery: A Systematic Review.","authors":"Isabella S D Faria, Daniel E Proença, Mayra L S Helfenstein, Catharina P Silva, Maria J A Araujo, Lara A Argolo","doi":"10.1007/s11695-024-07582-x","DOIUrl":"10.1007/s11695-024-07582-x","url":null,"abstract":"<p><p>Bariatric surgery is a common intervention for obesity but faces challenges, particularly due to its link with binge eating disorder (BED) and other psychological factors that impact outcomes. This systematic review of 22 articles from PubMed/Medline reveals a significant association between pre-surgical BED and reduced effectiveness in weight loss, with compulsive eating behaviors often persisting post-surgery. Traits like anxiety, depression, and emotional instability also compromise optimal results. These findings highlight the need for psychiatric interventions, both pre -and post-surgery, alongside continuous psychological support to enhance outcomes. Multidisciplinary approaches are crucial for sustainable results, with further research recommended to assess the impact of comprehensive psychological care, which plays a vital role in improving and maintaining the benefits of bariatric surgery.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5396-5403"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866203","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":"Cardiorespiratory and Metabolic Responses After Sleeve Gastrectomy in Adults With Obesity: Systematic Review.","authors":"Thanakorn Kaewnin, Sirapitch Manakhantikul, Jirawat Wattanapanyawech","doi":"10.1007/s11695-026-08861-5","DOIUrl":"10.1007/s11695-026-08861-5","url":null,"abstract":"<p><p>Following sleeve gastrectomy (SG), relative VO₂peak improves, yet absolute VO₂peak declines at all reported time points, revealing a paradoxical dissociation between apparent and actual aerobic capacity. This systematic review synthesizes very limited evidence from seven observational reports (n = 162, two independent cohorts) identified through PubMed, Scopus, CENTRAL, and ProQuest (2015-2025), restricted to studies using cardiopulmonary exercise testing with direct gas analysis. Oxygen uptake kinetics (τ) worsened at 1 and 6 months before trending toward baseline by 16 months. Walking economy improved through biomechanical adaptations. These findings are consistent with a possible period of metabolic vulnerability in the early post-SG months, during which tolerance to high-intensity exercise may be reduced. However, this hypothesis requires prospective validation.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5119-5130"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813794","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":"Weight Loss Threshold and Inflection Points for Biochemical Remission of Male Obesity-Associated Secondary Hypogonadism After Sleeve Gastrectomy.","authors":"Yian Zhao, Chong Cao, Rong Hua, Yuxiao Chu, Xiaozhuo Tan, Mengcheng He, Bo Xu, Qiwei Shen, Xiaojian Fu, Qiyuan Yao, Yikai Shao","doi":"10.1007/s11695-026-08923-8","DOIUrl":"10.1007/s11695-026-08923-8","url":null,"abstract":"<p><strong>Introduction: </strong>Male obesity-associated secondary hypogonadism (MOSH) is common in men with obesity and can improve following metabolic bariatric surgery (MBS). However, the quantitative relationship between postoperative weight loss and biochemical remission of MOSH remains unclear. This study aimed to characterize the nonlinear association between percentage total weight loss (TWL%) and MOSH remission after laparoscopic sleeve gastrectomy (LSG), and to identify clinically relevant weight-loss thresholds.</p><p><strong>Methods: </strong>This retrospective study included MOSH patients undergoing LSG with one-year follow-up. Restricted cubic spline (RCS) modeling evaluated the nonlinear relationship between TWL% and remission. Patients were grouped by RCS-derived thresholds, and logistic regression with interaction analyses examined the association and effect modification.</p><p><strong>Results: </strong>Among 230 patients, mean TWL% was 31.60% and remission rate was 82.17% at one year after LSG. RCS revealed a nonlinear association (P = 0.041) with an exploratory effect-initiation threshold at 21.8% TWL% and a suggested plateau period at 36.0% TWL%. Corresponding remission rates were 47.1% (< 21.8% TWL%), 88.9% (21.8-36.0% TWL%), and 87.1% (≥ 36.0% TWL%). Both higher TWL% groups had significantly greater odds of remission compared with the lowest group (adjusted odds ratio [aOR]: 10.61 and 10.64, respectively). Age, preoperative body mass index (BMI), and type 2 diabetes mellitus (T2DM) did not modify the relationship.</p><p><strong>Conclusion: </strong>Achieving 21.8% TWL% may represent an exploratory lower threshold for high remission probability, while 36.0% TWL% may indicate the onset of a plateau period. These findings provide preliminary reference points that require prospective validation before being considered for clinical guidance.</p><p><strong>Key points: </strong>• 21.8% TWL% may represent an exploratory minimum threshold for high MOSH remission probability after LSG. • 36.0% TWL% may indicate a plateau; further weight loss appears to yield no additional remission benefit. • These exploratory thresholds showed consistency across age, preoperative BMI, and T2DM subgroups in this cohort.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5145-5153"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866206","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":"Comparative Clinical Effectiveness and Operating Efficiency of Different Ultrasonic Devices for Performance of Sleeve Gastrectomy.","authors":"Misra Monali, I-Wen Pan, Zasim Azar Siddqui, Frank Bisceglie, Matthew Kroh","doi":"10.1007/s11695-026-08892-y","DOIUrl":"10.1007/s11695-026-08892-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate clinical and economic outcomes of using different ultrasonic energy devices in patients undergoing sleeve gastrectomy (SG).</p><p><strong>Methods: </strong>The patient cohort was extracted from PINC AI™ Healthcare Data 2019-2023, including individuals aged ≥ 18 who underwent primary elective gastric sleeve procedures using either corded (CD) or cordless (CL) ultrasonic devices (UD). Two analysis groups were evaluated: total SG regardless of the - stapler brand used in the operation (Cohort I), and UD used with an identifiable same-brand stapler in the operation (Cohort II). A propensity score matching (PSM) method with a caliper of 0.2 and 1:1 nearest-neighbor matching was performed for patients who used CD and CL. We applied multivariable generalized linear model (GLM) analyses for sensitivity analyses.</p><p><strong>Results: </strong>24160 and 18906 patients were included for cohorts I (82.3% CD and 17.7% CL; 4268 PSM paired) and II (81.7% CD and 18.3% CL; 3282 PSM paired), respectively. CD had higher operating-room time (minutes) than CL in both Cohort I (mean difference: 27 (95% confidence interval (CI): (24, 29), p < 0.001) and II (27 (24, 30), p < 0.001). There is no difference in incidence rates of blood transfusion, bleeding, and 30-day readmission, and total inpatient cost and length of stay between CD and CL. The sensitivity analyses showed similar results.</p><p><strong>Conclusions: </strong>The study shows that CL had similar clinical and economic outcomes to CD, and CL was more efficient in patients treated with sleeve gastrectomy.</p><p><strong>Key points: </strong>• Cordless ultrasonic devices were more efficient when used in sleeve gastrectomy. • Outcomes of sleeve gastrectomy used cordless/corded ultrasonic device were similar. • Resource use of cordless/corded ultrasonic device was similar in sleeve gastrectomy.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5173-5182"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796154","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":"Metabolic and Bariatric Surgery and Change in the AI-ECG-Derived Biological-Age Gap: A Longitudinal Cohort Study.","authors":"Reza Shahriarirad, Parvin Kalhor, Masoomeh Aslahishahri, Wissam Ghusn, Zachi Itzhak Attia, Nour El Ghazal, Omar Ghanem, Simon Laplante","doi":"10.1007/s11695-026-08945-2","DOIUrl":"10.1007/s11695-026-08945-2","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with accelerated aging, yet whether metabolic and bariatric surgery (MBS) can reverse or attenuate this process, as measured by the artificial intelligence-electrocardiogram (AI-ECG)-derived age gap, remains uncertain.</p><p><strong>Methods: </strong>We retrospectively studied 2,380 adults who underwent primary MBS from 2008 to 2023 and contributed 6,149 ECG observations. The outcome, δage, was AI-ECG-predicted age minus chronological age. Linear mixed-effects models used continuous time with a clinically prespecified 1-year knot and decomposed weight into between-person and within-person components. Secondary analyses evaluated alternative adiposity measures, observed ECG-age normalization, exploratory mediation, and mortality.</p><p><strong>Results: </strong>Median preoperative δage was 3.86 years (IQR, - 1.30 to 9.03), and 69.6% had δage > 0. δage changed by + 0.275 years/year during the first postoperative year (95% CI, - 0.187 to 0.738; P=.244) and by - 0.192 years/year thereafter (95% CI, - 0.303 to - 0.081; P=.001). The piecewise model was not superior to a linear model (P=.093). Higher between-person mean weight was associated with higher δage (+ 0.548 years per 10 kg; P<.001), whereas within-person weight change was not (+ 0.117 years per 10 kg; P=.084). Baseline, observed postoperative nadir, and maximum BMI were positively associated with δage; %EWL and observed weight regain were not. The exploratory indirect effect through weight change was near zero (ACME, + 0.0008 years; P=.814). Among 1,657 patients with baseline δage > 0, 335 (20.2%) had an observed δage ≤ 0 during follow-up.</p><p><strong>Conclusions: </strong>MBS was associated with a modest late decline in AI-ECG-derived δage. Chronic adiposity, but not within-person weight change, was associated with δage.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5093-5108"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977575","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}