Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity

doi:10.3748/wjg.v30.i13.1887

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World Journal of Gastroenterology

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Retrospective Study

World J Gastroenterol. Apr 7, 2024; 30(13): 1887-1898
Published online Apr 7, 2024. doi: 10.3748/wjg.v30.i13.1887

Table 1 Preoperative data of all patients (n = 193): Baseline information and obesity-related comorbidities, n (%)

Baseline	Total, n = 193
Sex (Females)	129 (66.8)
Age (yr, mean ± SD)	31.5 ± 8.2
Height (cm, mean ± SD)	169.3 ± 8.0
Weight (kg, mean ± SD)	119.6 ± 27.7
Body mass index (kg/m², mean ± SD)	41.3 ± 7.0
Waistline (cm, mean ± SD)	123.2 ± 17.2
Hipline (cm, mean ± SD)	129.4 ± 15.7
¹FAO	113 (58.5)
²FAO	58 (30.0)
Obesity-related comorbidities
Metabolic syndrome	88 (45.6)
Hypertension	67 (34.7)
Cardiovascular disease	10 (5.2)
Type 2 diabetes mellitus	94 (48.7)
Impaired glucose tolerance	78 (40.4)
Hyperlipoidemia	81 (42.0)
Obstructive sleep apnea	128 (66.3)
Polycystic ovarian syndrome (n = 129)	31 (24.0)
Non-alcoholic fatty liver disease	163 (84.5)
Gout	10 (5.2)
Hyperuricemia	114 (59.1)

The data in the table are n (%) or mean ± SD. FAO: Familial aggregation of obesity.

Table 2 Preoperative baseline information

	¹SO, n = 75	¹FAO, n = 75	P value	²SO, n = 54	²FAO, n = 54	P value
Sex [female, n (%)]	50 (66.7)	48 (64.0)	0.731	36 (66.7)	32 (59.3)	0.425
Age (yr)	29.5 ± 6.8	31.8 ± 9.1	0.234	31.7 ± 8.6	30.7 ± 8.6	0.548
Height (cm)	170.3 ± 7.9	170.1 ± 7.7	0.884	169.9 ± 7.2	170.4 ± 8.3	0.711
Body Weight (kg)	123.5 ± 30.4	122.2 ± 29.9	0.840	120.9 ± 28.6	124.2 ± 31.3	0.562
BMI (kg/m²)	42.2 ± 8.1	41.8 ± 7.5	0.795	41.5 ± 7.4	42.3 ± 7.9	0.591
Waistline (cm)	126.0 ± 18.3	124.1 ± 19.9	0.731	124.8 ± 19.8	124.3 ± 19.4	0.916
Hipline (cm)	128.3 ± 12.3	129.8 ± 16.5	0.744	128.0 ± 13.3	130.7 ± 17.4	0.459

The data in the table are n (%) or mean ± SD. SO: Sporadic obesity; FAO: Familial aggregation of obesity; BMI: Body mass index.

Table 3 Preoperative obesity-related comorbidities, n (%)

		n	¹SO, n = 80	¹FAO, n = 80	χ²	P value	n	²SO, n = 58	²FAO, n = 58	χ²	P value
MS	Without	89	43 (53.8)	46 (57.5)	0.228	0.633	67	34 (58.6)	33 (56.9)	0.035	0.851
MS	With	71	37 (46.3)	34 (42.5)	0.228	0.633	49	24 (41.4)	25 (43.1)	0.035	0.851
HTN	Without	105	54 (67.5)	51 (63.8)	0.249	0.618	75	33 (56.9)	42 (72.4)	3.056	0.080
HTN	With	55	26 (32.5)	29 (36.3)	0.249	0.618	41	25 (43.1)	16 (27.6)	3.056	0.080
T2DM	Without	86	43 (53.8)	43 (53.8)		> 0.999	59	31 (53.4)	28 (48.3)	0.310	0.577
T2DM	With	74	37 (46.3)	37 (46.3)		> 0.999	57	27 (46.6)	30 (51.7)	0.310	0.577
IGT	Without	89	45 (56.3)	44 (55.0)	0.025	0.874	71	33 (56.9)	38 (65.5)	0.908	0.341
IGT	With	71	35 (43.8)	36 (45.0)	0.025	0.874	45	25 (43.1)	20 (34.5)	0.908	0.341
HLP	Without	96	51 (63.8)	45 (56.3)	0.938	0.333	68	39 (67.2)	29 (50.0)	3.554	0.059
HLP	With	64	29 (36.3)	35 (43.8)	0.938	0.333	48	19 (32.8)	29 (50.0)	3.554	0.059
PCOS	Without	87	41 (74.5)	46 (80.7)	0.612	0.434	52	27 (77.1)	25 (73.5)	0.157	0.924
PCOS	With	25	14 (25.5)	11 (19.3)	0.612	0.434	17	8 (22.9)	9 (26.5)	0.157	0.924
NAFLD	Without	26	16 (20.0)	10 (12.5)	1.653	0.199	19	8 (13.8)	11 (19.0)	0.566	0.452
NAFLD	With	134	64 (80.0)	70 (87.5)	1.653	0.199	97	50 (86.2)	47 (81.0)	0.566	0.452
OSA	Without	53	27 (33.8)	26 (32.5)	0.028	0.867	37	14 (24.1)	23 (39.7)	3.215	0.073
OSA	With	107	53 (66.3)	54 (67.5)	0.028	0.867	79	44 (75.9)	35 (60.3)	3.215	0.073
HUA	Without	68	37 (46.3)	31 (38.8)	0.921	0.337	42	18 (31.0)	24 (41.4)	1.344	0.246
HUA	With	92	43 (53.8)	49 (61.3)	0.921	0.337	74	40 (69.0)	34 (58.6)	1.344	0.246

Only female participants were analyzed to compare polycystic ovarian syndrome prevalence. The number of females is 112 [¹sporadic obesity (SO) vs¹familial aggregation of obesity (FAO) = 55 vs 57] and 69 (²SO vs²FAO = 35 vs 34). SO: Sporadic obesity; FAO: Familial aggregation of obesity; MS: Metabolic syndrome; HTN: Hypertension; T2DM: Type 2 diabetes mellitus; IGT: Impaired glucose tolerance; HLP: Hyperlipoidemia; PCOS: Polycystic ovarian syndrome; NAFLD: Non-alcoholic fatty liver disease; OSA: Obstructive sleep apnea; HUA: Hyperuricemia.

Table 4 Postoperative body mass index, total weight loss percentage, excess weight loss percentage

		¹SO, n = 73	¹FAO, n = 73	P value	²SO, n = 53	²FAO, n = 53	P value
Baseline	Sex [female, n (%)]	49 (67.1)	49 (67.1)	> 0.999	36 (67.9)	33 (62.3)	0.541
	Age (yr)	30.5 ± 7.7	31.0 ± 8.5	0.706	31.6 ± 8.7	30.6 ± 8.3	0.537
	Height (cm)	169.2 ± 8.4	169.9 ± 8.1	0.617	169.8 ± 7.5	170.2 ± 8.5	0.817
	Body weight (kg)	118.8 ± 26.7	120.7 ± 27.4	0.660	123.2 ± 27.3	123.2 ± 31.3	0.995
	BMI (kg/m²)	41.2 ± 6.9	41.5 ± 6.8	0.802	42.4 ± 6.9	42.1 ± 7.9	0.842
	Waistline (cm)	123.0 ± 16.0	123.4 ± 17.3	0.892	124.9 ± 18.4	123.4 ± 19.3	0.725
	Hipline (cm)	128.8 ± 16.3	131.0 ± 14.4	0.439	131.0 ± 18.1	129.8 ± 17.1	0.771
BMI	Pre-op (kg/m²)	41.2 ± 6.9	41.5 ± 6.8	0.802	42.4 ± 6.9	42.1 ± 7.9	0.842
	1 month (kg/m²)	35.5 ± 5.9	36.2 ± 6.3	0.465	36.9 ± 5.7	36.9 ± 7.6	0.974
	3 months (kg/m²)	31.5 ± 5.4	32.4 ± 5.6	0.364	32.9 ± 5.3	33.0 ± 6.6	0.950
	6 months (kg/m²)	28.4 ± 4.9	29.3 ± 5.0	0.246	29.6 ± 4.9	29.9 ± 5.9	0.784
	12 months (kg/m²)	26.9 ± 4.8	27.1 ± 3.9	0.830	27.2 ± 4.4	28.6 ± 5.5	0.213
	24 months (kg/m²)	26.3 ± 5.1	28.2 ± 4.2	0.201	26.9 ± 4.2	31.3 ± 5.7	0.003
	36 months (kg/m²)	26.9 ± 5.1	29.3 ± 5.3	0.428	27.5 ± 4.0	32.2 ± 6.2	0.061
%TWL	1 month	13.8 ± 4.4	12.8 ± 3.2	0.116	12.7 ± 3.5	12.6 ± 3.9	0.896
	3 months	23.2 ± 5.3	21.8 ± 5.3	0.112	22.2 ± 4.2	21.6 ± 6.2	0.571
	6 months	30.9 ± 5.8	29.0 ± 6.8	0.072	29.9 ± 5.2	28.7 ± 7.2	0.323
	12 months	36.1 ± 7.5	32.7 ± 8.3	0.063	35.6 ± 6.8	32.0 ± 9.8	0.081
	24 months	37.4 ± 7.8	30.0 ± 12.6	0.025	36.6 ± 7.4	26.7 ± 12.5	0.006
	36 months	41.3 ± 11.7	27.4 ± 10.5	0.044	37.0 ± 11.6	26.4 ± 13.3	0.079
%EWL	1 month	33.2 ± 12.1	32.2 ± 16.9	0.675	29.1 ± 9.2	32.5 ± 19.9	0.262
	3 months	56.5 ± 16.5	54.4 ± 25.5	0.561	51.8 ± 12.8	54.5 ± 30.0	0.541
	6 months	74.9 ± 18.9	71.5 ± 28.9	0.399	69.8 ± 17.4	71.2 ± 32.5	0.771
	12 months	84.9 ± 24.8	79.8 ± 20.8	0.322	82.7 ± 22.4	75.2 ± 25.0	0.162
	24 months	89.1 ± 24.8	70.9 ± 27.0	0.025	83.9 ± 20.8	59.2 ± 25.2	< 0.001
	36 months	83.9 ± 25.1	66.7 ± 20.6	0.202	77.8 ± 22.8	56.9 ± 25.3	0.084

The data in the table are n (%) or mean ± SD. Analysis at 36 months is primarily focused on trend interpretation. SO: Sporadic obesity; FAO: Familial aggregation of obesity; BMI: Body mass index; %TWL: Total weight loss percentage; %EWL: Excess weight loss percentage; Pre-op: Pre-operation.

Table 5 Factors affecting percentage total weight loss

		1 month	3 months	6 months	12 months	24 months
%TWL	¹FAO	-1.036	-1.352	-1.838	-1.542	-5.123
	Sex	-0.361	-1.054	-1.798	-1.229	-1.227
	BMI	0.0280	0.096	0.250^b	0.444^a	0.672^a
	MS	0.091	-0.962	-1.006	-3.808	0.829
	HTN	0.876	0.864	0.082	-0.844	-5.728
	T2DM	-0.370	-0.283	-0.087	-0.376	-3.427
	HLP	0.980	1.030	-0.817	-1.203	-4.127
	NAFLD	-0.517	-0.410	-1.568	0.065	-0.958
	OSA	-0.371	0.939	1.033	2.752	3.023
	HUA	0.506	0.028	-0.039	2.115	2.590
%TWL	²FAO	-0.272	-0.671	-1.385	-3.164	-9.486^b
	Sex	1.046	0.461	1.013	2.693	2.206
	BMI	-0.039	0.054	0.156	0.285	0.618^a
	MS	-0.891	-0.860	-1.852	-1.634	-4.611
	HTN	0.306	0.810	-0.088	-2.749	-3.853
	T2DM	-0.338	-1.478	-1.548	0.198	-1.050
	HLP	1.318	1.867	0.690	-2.605	-0.980
	NAFLD	-0.113	-0.303	0.482	0.338	2.968
	OSA	-0.483	0.747	0.288	2.558	0.332
	HUA	-0.367	-1.384	-1.298	0.120	-0.298

^aP < 0.01.

^bP < 0.001.

¹SO vs¹FAO: VIF¹_FAO = 1.182, VIF_Sex = 2.056, VIF_BMI = 1.783, VIF_MS = 3.514, VIF_HT_N= 2.561, VIF_T2DM = 1.854, VIF_HLP = 1.726, VIF_NAFLD = 1.244, VIF_OSA = 2.057, VIF_HUA = 2.03. ²SO vs²FAO: VIF²_FAO = 1.067, VIF_Sex = 1.683, VIF_BMI = 1.74, VIF_MS = 3.553, VIF_HT_N= 1.663, VIF_T2DM = 1.908, VIF_HLP = 2.352, VIF_NAFLD = 1.19, VIF_OSA = 1.343, VIF_HUA = 1.369. The data in the table are unstandardized coefficients (β-values). FAO: Familial aggregation of obesity; BMI: Body mass index; MS: Metabolic syndrome; HTN: Hypertension; T2DM: Type 2 diabetes mellitus; HLP: Hyperlipoidemia; NAFLD: Non-alcoholic fatty liver disease; OSA: Obstructive sleep apnea; HUA: Hyperuricemia; VIF: Variance inflation factor.

Table 6 Factors affecting percentage of excess weight loss

		1 month	3 months	6 months	12 months	24 months
%EWL	¹FAO	-0.698	-1.238	-2.329	-4.439	-14.637
	Sex	3.531	4.486	2.864	-4.092	-1.340
	BMI	-1.100 ^c	-1.751 ^c	-1.903 ^c	-1.397 ^b	-0.757
	MS	-1.272	-4.902	-6.480	-10.983	2.548
	HTN	4.388	5.435	4.388	1.123	-13.696
	T2DM	2.464	3.318	4.445	0.240	-11.171
	HLP	0.807	1.271	-2.716	-4.837	-11.703
	NAFLD	-5.720	-8.292	-11.392 ^a	0.987	1.587
	OSA	-2.937	-0.133	-0.533	5.991	6.384
	HUA	0.940	-0.329	-1.269	2.565	2.079
%EWL	²FAO	2.067	1.089	-0.691	-7.224	-23.513 ^c
	Sex	6.912 ^a	8.730	10.880	5.487	7.279
	BMI	-1.145 ^c	-1.806 ^c	-2.054 ^c	-1.539 ^c	-0.666
	MS	-7.068	-8.342	-12.334	-6.298	-5.596
	HTN	5.569	9.484	8.283	-2.062	-8.179
	T2DM	3.291	0.925	0.717	-0.222	-10.684
	HLP	2.784	4.219	1.786	-7.448	-5.069
	NAFLD	-3.588	-6.218	-5.107	1.598	7.874
	OSA	-5.186	-3.097	-5.148	2.368	-2.031
	HUA	-2.054	-5.344	-5.365	-2.837	-5.233

^aP < 0.05.

^bP < 0.01.

^cP < 0.001.

The data in the table are unstandardized coefficients (β-values). FAO: Familial aggregation of obesity; BMI: Body mass index; MS: Metabolic syndrome; HTN: Hypertension; T2DM: Type 2 diabetes mellitus; HLP: Hyperlipoidemia; NAFLD: Non-alcoholic fatty liver disease; OSA: Obstructive sleep apnea; HUA: Hyperuricemia; %EWL: Percentage of excess weight loss; %TWL: Percentage of total weight loss.

Table 7 Obesity-related comorbidities at 6 months postoperatively, n (%)

		n	¹SO, n = 73	¹FAO, n = 73	χ²	P value	n	²SO, n = 53	²FAO, n = 53	χ²	P value
MS	Without	133	65 (89)	68 (93.2)	0.760	0.383	100	52 (98.1)	48 (90.6)		0.205
MS	With	13	8 (11.0)	5 (6.8)	0.760	0.383	6	1 (1.9)	5 (9.4)		0.205
HTN	Without	132	66 (90.4)	66 (90.4)		> 0.999	99	50 (94.3)	49 (92.5)		> 0.999
HTN	With	14	7 (9.6)	7 (9.6)		> 0.999	7	3 (5.7)	4 (7.5)		> 0.999
T2DM	Without	131	66 (90.4)	65 (89.0)	0.074	0.785	97	52 (98.1)	45 (84.9)		0.031
T2DM	With	15	7 (9.6)	8 (11.0)	0.074	0.785	9	1 (1.9)	8 (15.1)		0.031
HLP	Without	118	60 (82.2)	58 (79.5)	0.177	0.674	91	50 (94.3)	41 (77.4)	6.290	0.012
HLP	With	28	13 (17.8)	15 (20.5)	0.177	0.674	15	3 (5.7)	12 (22.6)	6.290	0.012
NAFLD	Without	96	55 (75.3)	41 (56.2)	5.962	0.015	65	40 (75.5)	25 (47.2)	8.949	0.003
NAFLD	With	50	18 (24.7)	32 (43.8)	5.962	0.015	41	13 (24.5)	28 (52.8)	8.949	0.003
HUA	Without	98	46 (63.0)	52 (71.2)		> 0.999	78	41 (77.4)	37 (69.8)	1.603	0.205
HUA	With	48	27 (37.0)	21 (28.8)		> 0.999	28	12 (22.6)	16 (30.2)	1.603	0.205

Significant postoperative remission of obesity-related comorbidities in all patient groups (P < 0.001). SO: Sporadic obesity; FAO: Familial aggregation of obesity; MS: Metabolic syndrome; HTN: Hypertension; T2DM: Type 2 diabetes mellitus; HLP: Hyperlipoidemia; NAFLD: Non-alcoholic fatty liver disease; HUA: Hyperuricemia.

Citation: Wang ZY, Qu YF, Yu TM, Liu ZL, Cheng YG, Zhong MW, Hu SY. Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity. World J Gastroenterol 2024; 30(13): 1887-1898
URL: https://www.wjgnet.com/1007-9327/full/v30/i13/1887.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i13.1887