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Introduction <p>Metabolic and bariatric surgery (MBS) provides high rates of remission of obesity-related medical conditions (ORMC). However, recurrence of previously resolved ORMC remains an important concern. There is limited data on predictors of obesity-related medical conditions recurrence (ORMCR).</p> Methods <p>A retrospective study was conducted of patients undergoing primary sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), or duodenal switch (DS) between 2008 and 2022. Patients with ≥ 36 months of follow-up, ≥ 20% total weight loss, and initial remission of type 2 diabetes mellitus (T2D), hypertension (HTN), hyperlipidemia (HLD), or obstructive sleep apnea (OSA) were included. ORMC resolution and recurrence were defined using prespecified criteria. Recurrent weight gain (RWG) was categorized as no RWG (≤ 20%), moderate RWG (&gt; 20%-≤50%), and severe RWG (&gt; 50%). Separate multivariable Cox regression models were constructed for each ORMCR outcome.</p> Results <p>Among 1,323 patients with remission of at least one ORMC, ORMCR occurred in 76 (16.2%) patients with T2D, 117 (21.3%) with HTN, 71 (19.0%) with HLD, and 40 (5.4%) with OSA. Severe RWG was independently associated with increased HLD recurrence. RYGB and DS were associated with lower risks of T2D and HLD recurrence compared with SG, whereas T2D and HTN recurrence were driven by insulin dependence and higher HbA1c for T2D, and greater antihypertensive medication burden and older age for HTN. White race was protective against HTN recurrence.</p> Conclusions <p>The metabolic benefits of MBS remained largely durable, with ORMCR driven more strongly by baseline disease severity and patient-specific factors than by RWG itself.</p>

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Beyond Initial Resolution: Predictors of Recurrence of Obesity-related Medical Conditions after Metabolic and Bariatric Surgery

  • 期刊论文

  • 发表日期：

    2026年7月10日

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  • Tony Boutros,
  • Wissam Ghusn,
  • Joseph Klim,
  • Nour El Ghazal,
  • Andre Acra,
  • Simon J. Laplante,
  • Omar M. Ghanem

摘要

Introduction

Metabolic and bariatric surgery (MBS) provides high rates of remission of obesity-related medical conditions (ORMC). However, recurrence of previously resolved ORMC remains an important concern. There is limited data on predictors of obesity-related medical conditions recurrence (ORMCR).

Methods

A retrospective study was conducted of patients undergoing primary sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), or duodenal switch (DS) between 2008 and 2022. Patients with ≥ 36 months of follow-up, ≥ 20% total weight loss, and initial remission of type 2 diabetes mellitus (T2D), hypertension (HTN), hyperlipidemia (HLD), or obstructive sleep apnea (OSA) were included. ORMC resolution and recurrence were defined using prespecified criteria. Recurrent weight gain (RWG) was categorized as no RWG (≤ 20%), moderate RWG (> 20%-≤50%), and severe RWG (> 50%). Separate multivariable Cox regression models were constructed for each ORMCR outcome.

Results

Among 1,323 patients with remission of at least one ORMC, ORMCR occurred in 76 (16.2%) patients with T2D, 117 (21.3%) with HTN, 71 (19.0%) with HLD, and 40 (5.4%) with OSA. Severe RWG was independently associated with increased HLD recurrence. RYGB and DS were associated with lower risks of T2D and HLD recurrence compared with SG, whereas T2D and HTN recurrence were driven by insulin dependence and higher HbA1c for T2D, and greater antihypertensive medication burden and older age for HTN. White race was protective against HTN recurrence.

Conclusions

The metabolic benefits of MBS remained largely durable, with ORMCR driven more strongly by baseline disease severity and patient-specific factors than by RWG itself.