Gastrointestinal quality of life following bariatric surgery in Asian patients.

BACKGROUND/AIMS: Bariatric surgery is the only proven method that produces sustained weight loss. We aimed to investigate the Gastrointestinal Quality of Life Index (GIQLI) differences between obese patients following laparoscopic mini-gastric bypass (LMGB), laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in this study. METHODOLOGY: From December 2005 to December 2007, we enrolled 152 patients who received bariatric surgery, including 41 men and 111 women, mean age 32.6±9.4 years and mean BMI 37.4±7.9kg/m2 (range 32.0-64.9). Clinical characteristics and quality of life were analyzed. RESULTS: One year after bariatric surgery, the mean general score of GIQLI improved significantly (p=0.000). All patients had improvement in three domains of the questionnaire (social function, physical status and emotional status) but not in gastrointestinal symptoms. The preoperative general score was 105.9±15.4 points in LMGB group, 110.9±14.8 points in LAGB group and 99.0±19.8 points in LSG group, respectively. Despite a significant difference between three groups regarding preoperative GIQLI scores (p=0.001), the 1-year results failed to show any significant difference in a comparison of postoperative GIQLI scores (p=0.082). CONCLUSIONS: In conclusion, our study has demonstrated significant improvement in quality of life 1-year after laparoscopic bariatric surgery. The improvement of GIQLI scores in three domains of social function, physical status and emotional status can be offered to obese patients before surgery.

Predictors of anemia after bariatric surgery using multivariate adaptive regression splines.

BACKGROUND/AIMS: Anemia is the most common nutritional deficiency after bariatric surgery. The predictors of anemia have not been clearly identified. This issue is useful for selecting an appropriate surgery procedure for morbid obesity. METHODOLOGY: From December 2000 to October 2007, a retrospective study of 442 obese patients after bariatric surgery with two years' follow-up data was conducted. Anemia was defined by hemoglobin (Hb) under 13mg/dL in male and 11.5mg/dL in female. We analyzed the clinical information and laboratory data during the initial evaluation of patients referred to bariatric surgery for predictors of anemia development after surgery. All data were analyzed by using multivariate adaptive regression splines (MARS) method. RESULTS: Of the patients, the mean age was 30.8±8.6 years; mean BMI was 40.7±7.8kg/m2 and preoperative mean hemoglobin (Hb) was 13.7±1.5g/ dL. The prevalence of anemia increased from preoperatively 5.4% to 38.0% two years after surgery. Mean Hb was significantly lower in patients receiving gastric bypass than in restrictive type surgery (11.9mg/dL vs. 13.1mg/dL, p=0.040) two years after surgery. Besides, the preoperative optimal value of hemoglobin to predict future anemia in MARS model is 15.6mg/dL. CONCLUSIONS: The prevalence of anemia increased to 38.0% two years after bariatric surgery. We obtained an optimal preoperative value of hemoglobin 15.6mg/dL to predict postoperative anemia, which was important in preoperative assessment for bariatric surgery. Patients undergone gastric bypass surgery developed more severe anemia than gastric banding or sleeve gastrectomy.

Evaluation of quality of life and impact of personality in Chinese obese patients following laparoscopic sleeve gastrectomy.

BACKGROUND/AIMS: The effectiveness of laparoscopic sleeve gastrectomy (LSG) in measuring the quality of life (QOL) and personality in obese patients has not been previously investigated. This study aims to investigate different clinical outcome variables, the relationships between quality of life and different personality one-year after LSG in obese patients. METHODOLOGY: Sixty-one consecutive obese patients (49 females) who underwent LSG were evaluated for clinical characteristics after weight reduction. Chinese Personality Assessment Inventory and Gastrointestinal Quality-of-Life Index (GIQLI) were analyzed. RESULTS: One year after LSG, mean body weight (BW), mean body mass index (BMI) and excess weight loss (EWL) were 66.5±13.6kg, 24.4±4.4kg/m2 and 88.1±32.5%, respectively. Metabolic syndrome decreased from 45.1% to 9.8%. The significant variables were systolic blood pressure, fasting glucose, triglyceride, uric acid, aspartate aminotransferase, alanine aminotransferase, insulin, high sensitivity C-reactive protein, HbA1c, C-peptide and HOMA. All patients demonstrated improvement in two domains of the questionnaire (physical status and emotion status), but not in gastrointestinal symptoms. Although the 'Agreeableness' dimension of Chinese personality had a lower presenting BMI (23.9kg/m2) and better excess weight loss (88.0%), this group showed less improvement in gastrointestinal symptoms and had poorer physical status. CONCLUSIONS: LSG provided meaningful weight loss and improvement in quality of life. Chinese personality was the predictor of weight loss and GIQLI.

How COVID-19 Triggers Our Herding Behavior? Risk Perception, State Anxiety, and Trust.

People have felt afraid during the outbreak of coronavirus disease 2019 (COVID-19), because a virus is an invisible enemy. During the pandemic outbreak, society has become worried about the spread of infections and the shortage of protective equipment. This common fear among the public subsequently deepens each person's fear, increasing their belief in the content reported by the media and thus actively compelling these individuals to engage in the behavior of panic buying. In this study, we explored the effects of the public's risk perception, state anxiety, and trust in social media on the herding effect among individuals. The study was based on an online questionnaire survey and convenience sampling. The results showed that the public's risk perception increased their state anxiety and then deepened their willingness to wait in line for a purchase. In addition, the more people that trust the message delivered by the media, the more actively they will join the queue to buy goods. This study also found that anxiety had a greater impact on the public's willingness to wait for a purchase than trust in social media. Therefore, the top priority for the government should be to reduce the public's state anxiety and then reduce the herding effect.

Prediction of successful weight reduction after laparoscopic adjustable gastric banding.

BACKGROUND/AIM: Compared with conventional pharmacological therapies, bariatric surgery has been shown to cause greater and- sustained weight loss. It was aimed to evaluate weight loss in obese patients after laparoscopic adjustable gastric banding surgery using information typically available during the initial evaluation studied before bariatric surgery and genes. METHODOLOGY: 74 patients undergoing laparoscopic adjustable gastric banding (LAGB) were enrolled. Artificial Neural Network technology was used to predict weight loss. RESULTS: We studied 74 patients consisting of 22 men and 52 women 2 years after operation. Mean age was 31.7 +/- 9.1 years. 27 (36.5%) patients had successful weight reduction (excess weight loss >50%) while 47 (63.5%) did not. ANN provided predicted factors on gender, insulin, albumin and two genes: re4684846_r, rs660339_r which were associated with success. CONCLUSION: Artificial neural network is a better modeling technique and the predictive accuracy is higher on the basis of multiple variables related to laboratory tests. Our finding gave demonstrated result that obese patients of successful weight reduction after laparoscopic adjustable gastric banding surgery were women, having little lower insulin and albumin, and carrying GG genotype on rs4684846 and with at least one T allele on rs660339. In these cases, weight loss will give better results.

Obesity and the decision tree: predictors of sustained weight loss after bariatric surgery.

BACKGROUND/AIMS: Bariatric surgery is the only long-lasting effective treatment to reduce body weight in morbid obesity. Previous literature in using data mining techniques to predict weight loss in obese patients who have undergone bariatric surgery is limited. This study used initial evaluations before bariatric surgery and data mining techniques to predict weight outcomes in morbidly obese patients seeking surgical treatment. METHODOLOGY: 251 morbidly obese patients undergoing laparoscopic mini-gastric bypass (LMGB) or adjustable gastric banding (LAGB) with complete clinical data at baseline and at two years were enrolled for analysis. Decision Tree, Logistic Regression and Discriminant analysis technologies were used to predict weight loss. Overall classification capability of the designed diagnostic models was evaluated by the misclassification costs. RESULTS: Two hundred fifty-one patients consisting of 68 men and 183 women was studied; with mean age 33 years. Mean +/- SD weight loss at 2 year was 74.5 +/- 16.4 kg. During two years of follow up, two-hundred and five (81.7%) patients had successful weight reduction while 46 (18.3%) were failed to reduce body weight. Operation methods, alanine transaminase (ALT), aspartate transaminase (AST), white blood cell counts (WBC), insulin and hemoglobin A1c (HbA1c) levels were the predictive factors for successful weight reduction. CONCLUSION: Decision tree model was a better classification models than traditional logistic regression and discriminant analysis in view of predictive accuracies.