Red cell distribution width is a novel biomarker that predicts excess body-mass index loss 1 year after laparoscopic Roux-en-Y gastric bypass.
Red cell distribution width is a novel biomarker that predicts excess body-mass index loss 1 year after laparoscopic Roux-en-Y gastric bypass.
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DOI：
10.1007/s00464-016-4798-9
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发表时间：
2016-10
期刊：
影响因子：
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通讯作者：
Kligman MD
中科院分区：
文献类型：
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作者：
Wise ES;Hocking KM;Weltz A;Uebele A;Diaz JJ;Kavic SM;Kligman MD
减肥手术是实现持续减肥、改善肥胖相关并发症和减少病态肥胖人群炎症的最有效方法。红细胞分布宽度(RDW)是一种新的炎症标志物，通常被报告为完整血细胞计数的一部分。在这项研究中，我们验证了我们的假设，即红细胞分布宽度可能代表一种新的预测腹腔镜Roux-en-Y胃分流术(LRYGB)后过度体重指数下降(EBMIL)的生物标志物。来自单一机构的547名LRYGB患者被单独审查，记录了术前RDW和LRYGB后6个月和1年的超额体重指数损失百分比(分别为%EBMIL180和%EBMIL365)。对年龄、性别、初始体重指数(BMI0)和RDW以及两个终点之间进行二元和多元线性回归分析，以评估RDW的独立性作为术后成功的预测因素。RDW中位数为13.9(13.3~14.6)%，EBMIL180和EBMIL365中位数分别为55.4(45.2~66.7)%和71.3(58.9~87.8)%。在控制了年龄、性别和体重指数0后，RDW与%EBMIL365(B=−1.4[−2.8-−0.002]%，P=0.05)相关，但与%EBMIL180(B=−0.6[−1.6-0.5]%，P=0.30)无关。经Kruskal-Wallis分析，术前RDW>；15.0%的患者的EBMIL显著低于RDW>；15.0%的患者(P<；.001)和13.0-15.0%的患者(P<；0.01)。RDW对LRYGB后一年的EBMIL有预测作用。这代表了一种新的术前生物标志物，可以提供临床上有用的预后信息。
Bariatric surgery is the most effective method for producing sustained weight loss, improving obesity-associated comorbidities and reducing inflammation in the morbidly obese population. The red cell distribution width (RDW) is a novel marker of inflammation that is usually reported as part of a complete blood count. In this study, we tested our hypothesis that red cell distribution width might represent a novel biomarker predictive of excess body-mass index loss (EBMIL) following laparoscopic Roux-en-Y gastric bypass (LRYGB). Five hundred and forty-seven included LRYGB patients from a single institution were individually reviewed, noting both pre-operative RDW and percent excess BMI loss at six months and one year post-LRYGB (%EBMIL180 and %EBMIL365, respectively). Bivariate and multivariate linear regression analysis was conducted between age, gender, initial body-mass index (BMI0) and RDW and each of the two endpoints, to assess the independence of RDW as a predictor of post-operative success. The median RDW was 13.9 (13.3 – 14.6)%, and median EBMIL180 and EBMIL365 were 55.4 (45.2 – 66.7)% and 71.3 (58.9 – 87.8)%, respectively. After controlling for age, gender and BMI0, RDW was associated with %EBMIL365 (B = −1.4 [−2.8 – −0.002]%, P = .05), but not %EBMIL180 (B = −0.6 [−1.6 – 0.5]%, P = .30. Upon Kruskal-Wallis analysis, patients with a pre-operative RDW > 15.0% had significantly lower %EBMIL than those in the <13.0% (P < .001) and 13.0–15.0% (P < .01) strata. RDW is predictive of EBMIL at one year following LRYGB. This represents a novel pre-operative biomarker that may provide clinically useful prognostic information.