Low serum insulin-like growth factor-1 level is a predictor of low total weight loss percentage after sleeve gastrectomy

Abstract

Background: Obesity is a leading cause of metabolic disorders and mortality. Laparoscopic sleeve gastrectomy (LSG) confers beneficial effects not only on weight but also on metabolic disorder development. However, some patients show insufficient weight loss after LSG. A total weight loss percentage (%TWL) <20% after LSG is defined as insufficient. The prediction of patients with insufficient weight loss after LSG before the procedure is performed may prove helpful.

Objectives: To determine predictors of %TWL after LSG.

Setting: Longitudinal study in a university hospital.

Methods: We retrospectively reviewed 90 obese patients who underwent LSG and were followed up for 12 months thereafter. We analyzed the relationship between %TWL and preoperative clinical parameters, such as age, sex, body mass index, lipid and glucose metabolism, and some hormones. Patients were divided into 2 groups, %TWL <20% and 20% ≤ %TWL. Multiple regression model and logistic regression models were performed.

Results: LSG led to significant improvements in weight, liver, and kidney function, and lipid and glucose metabolism. The serum insulin-like growth factor-1 (IGF-1) level was significantly lower in patients with %TWL <20%. Sex, diabetes presence, body mass index, and IGF-1 were independent predictors of %TWL. Receiver operating characteristic curve analysis showed that the cutoff value of IGF-1 for %TWL <20% was 100.0ng/mL. Male sex, diabetes presence, lower preoperative BMI, and IGF-1 values were independently associated with lower %TWL (%TWL <20%).

Conclusions: Serum IGF-1 can be used to screen for patients at risk of low %TWL after LSG.

Keywords: Insulin-like growth factor-1; Laparoscopic sleeve gastrectomy; Obesity; Total weight loss.