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. 2022 Apr;32(4):1184-1192.
doi: 10.1007/s11695-022-05916-1. Epub 2022 Feb 9.

Development of a New Index Based on Preoperative Serum Lipocalin 2 to Predict Post-LSG Weight Reduction

Nannan Li #  1 , Bei Xu #  1 , Jiangping Zeng  1 , Shihui Lei  1 , Lei Gu  2 , Lijin Feng  3 , Bing Zhu  1 , Yueye Huang  1 , Lu Wang  1 , Lili Su  1 , Shen Qu  1 , Xiaoyun Cheng  4 , Le Bu  5
Affiliations

Development of a New Index Based on Preoperative Serum Lipocalin 2 to Predict Post-LSG Weight Reduction

Nannan Li et al. Obes Surg. 2022 Apr.

Abstract

Background: Bariatric surgery is the most effective therapy for obesity, but targeted weight reduction is not always achieved. Serum lipocalin-2 (LCN2) is closely associated with obesity, but its impact on weight loss after surgery is unknown. We aimed to access the reliability of LCN2 levels and other parameters as effective predictors of excellent weight loss (≥ 75% excess weight loss (EWL)) 1 year after bariatric surgery.

Methods: This retrospective study evaluated 450 patients (aged 18-65 years) with obesity at 3 months and 1 year after laparoscopic sleeve gastrectomy (LSG) surgery. Seventy-four patients who underwent LSG surgery and met the inclusion and exclusion criteria were included in this study. Serum LCN2, thyroid function, and metabolic and anthropometric parameters were assessed. Weight reduction was expressed as %EWL and percent total weight loss (%TWL) at 3 months and 1 year post surgery. Multivariable logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to evaluate predictors of ≥ 75%EWL.

Results: In our cohort, %EWL and %TWL were both strongly associated with preoperative serum LCN2 levels. The binary logistic regression analysis showed that preoperative LCN2, waist circumference, and glycated hemoglobin were independent predictors of excellent weight loss.

Conclusions: Based on these results, we determined a new P index with better predictive value for excellent weight reduction (≥ 75%EWL) 1 year after LSG surgery.

Keywords: Bariatric surgery; Lipocalin-2; Obesity; Weight loss.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Follow-up study flow chart on patients with obesity subjected to laparoscopic sleeve gastrectomy (LSG) surgery at 3 and 12 months
Fig. 2
Fig. 2
Weight loss plot over time. Values are shown as the mean values of %EWL by the circle dots and %TWL by the square dots, and standard deviation of both by vertical lines. Percent extra weight loss (%EWL) was calculated by the formula: ((preoperative weight − current weight) / (preoperative weight − ideal weight to produce BMI 24 kg/m2) × 100); percent total weight loss (%TWL) was defined by the formula: ((preoperative weight − current weight) / (preoperative weight) × 100). 0 m baseline, 3 m 3-month follow-up after laparoscopic sleeve gastrectomy (LSG) surgery, 12 m 12-month follow-up after LSG surgery
Fig. 3
Fig. 3
Receiver operating characteristic (ROC) curve for serum lipocalin-2 (red line), waist circumference (blue line), and new P index (orange line) respectively in the prediction of a surgery response of ≥ 75% EWL 1 year after LSG surgery
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