Qais AbuHasan, Luke M Funk, Jane L Holl, Claire Draucker, Shaun Grannis, Karl Y Bilimoria, Dimitrios Stefanidis, Tarik K Yuce
{"title":"术前胰高血糖素样肽-1受体激动剂的使用及其与减肥手术结果的关系。","authors":"Qais AbuHasan, Luke M Funk, Jane L Holl, Claire Draucker, Shaun Grannis, Karl Y Bilimoria, Dimitrios Stefanidis, Tarik K Yuce","doi":"10.1007/s11695-024-07651-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The efficacy of Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) for the treatment of obesity has led to considerably increased demand for these medications. GLP1RA use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to (1) describe trends in pre-bariatric GLP1RA use, (2) investigate social and clinical factors associated with their use, and (3) evaluate differences in clinical outcomes based on preoperative GLP1RA use.</p><p><strong>Methods: </strong>Patients who underwent bariatric surgery at three Indiana hospitals from 2018 to 2023 were identified. Patients who utilized GLP1RA in the year preceding surgery were compared to those who did not. Social factors included insurance, income, and unemployment. Outcomes included rates of GLP1RA use, 30-day postoperative readmissions, ED visits, and percent total weight lost (%TWL) at 1 year. Associations between preoperative GLP1RA use and outcomes of interest were evaluated using multivariable logistic and linear regressions.</p><p><strong>Results: </strong>Of 2169 patients who underwent surgery, 293 (13.5%) utilized GLP1RA preoperatively. The rate of GLP1RA utilization increased threefold from 2018 to 2023. Males were more likely to receive preoperative GLP1RA (20.1% vs, 12.2%, p<0.001). There were no significant differences in social determinants of health or 30-day postoperative outcomes between patients who did and did not use GLP1RA preoperatively. Similarly, there were no significant differences in %TWL at 1 year postoperatively between groups (median 25.5% vs. 27.3%, coefficient, -0.78, 95%CI, -2.26 to 0.70).</p><p><strong>Conclusions: </strong>Utilization of GLP1RA in the year prior to bariatric surgery has increased threefold. Preoperative GLP1RA use is not associated with worse 30-day outcomes or differences in %TWL at 1 year postoperatively. Further work is needed to evaluate whether GLP1RA dosing and duration of treatment impact postoperative outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"556-560"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835518/pdf/","citationCount":"0","resultStr":"{\"title\":\"Preoperative Glucagon-Like Peptide-1 Receptor Agonist Utilization and Association with Bariatric Surgery Outcomes.\",\"authors\":\"Qais AbuHasan, Luke M Funk, Jane L Holl, Claire Draucker, Shaun Grannis, Karl Y Bilimoria, Dimitrios Stefanidis, Tarik K Yuce\",\"doi\":\"10.1007/s11695-024-07651-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The efficacy of Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) for the treatment of obesity has led to considerably increased demand for these medications. GLP1RA use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to (1) describe trends in pre-bariatric GLP1RA use, (2) investigate social and clinical factors associated with their use, and (3) evaluate differences in clinical outcomes based on preoperative GLP1RA use.</p><p><strong>Methods: </strong>Patients who underwent bariatric surgery at three Indiana hospitals from 2018 to 2023 were identified. Patients who utilized GLP1RA in the year preceding surgery were compared to those who did not. Social factors included insurance, income, and unemployment. Outcomes included rates of GLP1RA use, 30-day postoperative readmissions, ED visits, and percent total weight lost (%TWL) at 1 year. Associations between preoperative GLP1RA use and outcomes of interest were evaluated using multivariable logistic and linear regressions.</p><p><strong>Results: </strong>Of 2169 patients who underwent surgery, 293 (13.5%) utilized GLP1RA preoperatively. The rate of GLP1RA utilization increased threefold from 2018 to 2023. Males were more likely to receive preoperative GLP1RA (20.1% vs, 12.2%, p<0.001). There were no significant differences in social determinants of health or 30-day postoperative outcomes between patients who did and did not use GLP1RA preoperatively. Similarly, there were no significant differences in %TWL at 1 year postoperatively between groups (median 25.5% vs. 27.3%, coefficient, -0.78, 95%CI, -2.26 to 0.70).</p><p><strong>Conclusions: </strong>Utilization of GLP1RA in the year prior to bariatric surgery has increased threefold. Preoperative GLP1RA use is not associated with worse 30-day outcomes or differences in %TWL at 1 year postoperatively. Further work is needed to evaluate whether GLP1RA dosing and duration of treatment impact postoperative outcomes.</p>\",\"PeriodicalId\":19460,\"journal\":{\"name\":\"Obesity Surgery\",\"volume\":\" \",\"pages\":\"556-560\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835518/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obesity Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11695-024-07651-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obesity Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11695-024-07651-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/14 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Preoperative Glucagon-Like Peptide-1 Receptor Agonist Utilization and Association with Bariatric Surgery Outcomes.
Background: The efficacy of Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) for the treatment of obesity has led to considerably increased demand for these medications. GLP1RA use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to (1) describe trends in pre-bariatric GLP1RA use, (2) investigate social and clinical factors associated with their use, and (3) evaluate differences in clinical outcomes based on preoperative GLP1RA use.
Methods: Patients who underwent bariatric surgery at three Indiana hospitals from 2018 to 2023 were identified. Patients who utilized GLP1RA in the year preceding surgery were compared to those who did not. Social factors included insurance, income, and unemployment. Outcomes included rates of GLP1RA use, 30-day postoperative readmissions, ED visits, and percent total weight lost (%TWL) at 1 year. Associations between preoperative GLP1RA use and outcomes of interest were evaluated using multivariable logistic and linear regressions.
Results: Of 2169 patients who underwent surgery, 293 (13.5%) utilized GLP1RA preoperatively. The rate of GLP1RA utilization increased threefold from 2018 to 2023. Males were more likely to receive preoperative GLP1RA (20.1% vs, 12.2%, p<0.001). There were no significant differences in social determinants of health or 30-day postoperative outcomes between patients who did and did not use GLP1RA preoperatively. Similarly, there were no significant differences in %TWL at 1 year postoperatively between groups (median 25.5% vs. 27.3%, coefficient, -0.78, 95%CI, -2.26 to 0.70).
Conclusions: Utilization of GLP1RA in the year prior to bariatric surgery has increased threefold. Preoperative GLP1RA use is not associated with worse 30-day outcomes or differences in %TWL at 1 year postoperatively. Further work is needed to evaluate whether GLP1RA dosing and duration of treatment impact postoperative outcomes.
期刊介绍：
Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions.
Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.
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