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首页> 外文期刊>Obesity surgery >Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients.
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Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients.

机译：减肥手术的相对结果量度。一系列腹腔镜Roux-en-Y胃搭桥手术患者避免过度减肥和过度体重指数降低的证据。

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BACKGROUND: Bariatric results expressed in the relative measure excess weight loss (%EWL) vary significantly by initial body mass index (BMI): the heavier the patient, the lower the %EWL. We examine if this variation is caused by using a wrong outcome measure and argue that no relative weight loss measure can express bariatric or metabolic goals unequivocally. METHODS: Nadir weight loss results after laparoscopic gastric bypass in 168 women with initial BMI >/=35 to <60 kg/m2 are calculated for %EWL and 61 different relative measures using the formula 100% x (initial BMI - nadir BMI) / (initial BMI-a), with a ranging from -30 to +30. Standard deviations are compared mutually and with those reported in the literature. For each relative measure, the significance of any variation by initial BMI is determined with the Mann-Whitney U test. RESULTS: Mean initial BMI was 44.9 +/- 6.7 (35.0-59.7) kg/m2. Mean nadir BMI was 28.8 +/- 5.8 (18.5-44.4) kg/m2. Mean nadir excess BMI loss (%EBL; a = 25) was 87.0 +/- 28.0 (19.4-155.1)%. Mean nadir (total) weight loss (%TWL; a = 0) was 35.9 +/- 8.5 (9.5-57.1)%. Mean nadir %EWL was 77.3 +/- 22.8 (17.7-135.2)%. The smallest variation coefficient was 23.7% at a ranging from -1 to +3, including %TWL (a = 0). This is lower than variation coefficients of %EWL results in our series and in the literature. Variation by initial BMI is significant using relative measures with a >/=3, including %EBL and %EWL (both p < 0.0001) and not significant with a <3, including %TWL (p = 0.13). CONCLUSIONS: In contrast to their widespread use, %EBL and %EWL are not suited for comparing different patients or nonrandomized groups. They cause variation by initial BMI, which disappears using %TWL. In general, absolute terms should be preferred for bariatric outcome and goals. The power of bariatric procedures is best represented by their mean %TWL value.
机译：背景：以相对度量过重体重减轻（％EWL）表示的减肥结果因初始体重指数（BMI）而显着不同：患者越重，％EWL越低。我们检查这种变化是否是由于使用了错误的结果度量引起的，并争论说没有相对的减肥度量可以明确表达减肥或代谢目标。方法：采用公式100％x（初始BMI-最低BMI）/公式计算了168例初始BMI> / = 35至<60 kg / m2的妇女在腹腔镜胃旁路手术后的最低体重减轻百分比和61种不同的相对测量值（初始BMI-a），范围从-30到+30。相互比较标准偏差，并与文献中的标准偏差进行比较。对于每个相对量度，使用Mann-Whitney U检验确定初始BMI引起的任何变化的显着性。结果：平均初始BMI为44.9 +/- 6.7（35.0-59.7）kg / m2。平均最低体重指数为28.8 +/- 5.8（18.5-44.4）kg / m2。平均天底过量BMI损失（％EBL; a = 25）为87.0 +/- 28.0（19.4-155.1）％。平均最低体重（总）体重减轻（％TWL; a = 0）为35.9 +/- 8.5（9.5-57.1）％。平均最低天数％EWL为77.3 +/- 22.8（17.7-135.2）％。最小变异系数为23.7％，范围为-1至+3，包括％TWL（a = 0）。这低于我们系列和文献中％EWL结果的变异系数。初始BMI的变化使用> / = 3（包括％EBL和％EWL）的相对测量值均显着（均p <0.0001），而对于<3，包括％TWL（p = 0.13）则不显着。结论：与广泛使用相反，％EBL和％EWL不适合比较不同的患者或非随机组。它们由初始BMI引起变化，而BMI使用％TWL消失。一般而言，肥胖治疗的结果和目标应首选绝对术语。减肥手术的功效最好用其平均％TWL值表示。

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