Evaluation of the relationship between combined scores derived from pre-operative routine parameters and weight loss following sleeve gastrectomy: A retrospective cohort study
NORTHERN CLINICS OF ISTANBUL, cilt.13, sa.3, ss.280-287, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 13 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.14744/nci.2026.89814
- Dergi Adı: NORTHERN CLINICS OF ISTANBUL
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), Directory of Open Access Journals, TR DİZİN (ULAKBİM), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.280-287
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Ankara Üniversitesi Adresli: Hayır
Özet
OBJECTIVE: This study aimed to investigate whether pre-operative composite indices derived from routine laboratory parameters, namely the fibrosis-4 (FIB-4) index, the aspartate aminotransferase-to-platelet ratio index (APRI), and the homeostatic model assessment of insulin resistance (HOMA-IR), were associated with post-operative percentage of excess weight loss (%EWL) after laparoscopic sleeve gastrectomy (LSG).
METHODS: This retrospective cohort study included 91 adults who underwent LSG at a tertiary referral center. Pre-operative FIB-4, APRI, and HOMA-IR values were calculated from routinely obtained clinical and biochemical parameters. The primary endpoint was %EWL during post-operative follow-up. Patients were also classified as successful (%EWL >= 50%) or suboptimal (%EWL <50%) responders. Comparative analyses, correlation analyses, and multivariable linear regression were performed.
RESULTS: The cohort had a mean age of 39.2 +/- 10.0 years and was predominantly female (80.2%). Mean baseline body mass index (BMI) was 45.1 +/- 6.3 kg/m(2). Mean post-operative %EWL was 51.0 +/- 20.2%, whereas total weight loss reached 26.5 +/- 8.4%. Marked post-operative metabolic improvement was observed, including significant declines in HOMA-IR, fasting glucose, triglycerides, alanine aminotransferase, and glycated hemoglobin. However, neither FIB-4 nor APRI nor HOMA-IR demonstrated a significant linear association with %EWL, and none remained an independent predictor in the regression model adjusted for age and baseline BMI. In subgroup analyses, the suboptimal weight loss group had a significantly higher baseline BMI and a borderline-higher triglyceride level.
CONCLUSION: Pre-operative FIB-4, APRI, and HOMA-IR appear valuable for metabolic and hepatic phenotyping before surgery, but they do not provide sufficient standalone prognostic discrimination for early post-operative %EWL after LSG. Baseline adiposity may remain more informative than these composite indices for identifying patients at risk of suboptimal relative weight loss.