Summary:
In adults undergoing laparoscopic sleeve gastrectomy (LSG) for obesity and metabolic disorders, a preoperative predictive nomogram combining HDL-C levels and baseline visceral adipose tissue measurements demonstrated excellent predictive accuracy for VAT reduction (AUC 0.88 in validation cohort), significantly outperforming single-parameter assessments compared to standard preoperative assessment using individual anthropometric or metabolic parameters alone, with the model enabling individualized outcome prediction without adverse effects.
| PICO | Description |
|---|---|
| Population | Adults undergoing laparoscopic sleeve gastrectomy (LSG) for obesity and metabolic disorders. |
| Intervention | Preoperative predictive nomogram combining HDL-C levels and baseline visceral adipose tissue measurements. |
| Comparison | Standard preoperative assessment using individual anthropometric or metabolic parameters alone. |
| Outcome | Excellent predictive accuracy for VAT reduction (AUC 0.88), significantly outperforming single-parameter assessments. |
Clinical Context
Visceral adipose tissue (VAT) reduction may be more metabolically relevant than total weight loss. Predicting which patients will achieve optimal VAT reduction could improve counseling.
Clinical Pearls
1. High Predictive Accuracy: An AUC of 0.88 represents excellent discriminatory ability.
2. HDL-C as Metabolic Marker: HDL-C likely serves as a marker of underlying metabolic health and VAT biology.
3. VAT vs Total Weight: Body composition changes matter more than scale weight for metabolic outcomes.
4. Nomogram Approach: Provides individualized risk estimates based on specific patient values.
Practical Application
Obtain both HDL-C levels and VAT measurement during preoperative evaluation. Use combined assessment to predict likely VAT reduction and counsel patients accordingly.
Study Limitations
Single-center study requiring external validation. VAT measurement methods vary across institutions.
Bottom Line
A prediction model combining preoperative HDL-C and visceral adipose tissue accurately predicts VAT reduction after sleeve gastrectomy (AUC 0.88).
Source: Sun Y, et al. “HDL-C and Visceral Adipose Tissue as Combined Predictors of Visceral Fat Changes Following Laparoscopic Sleeve Gastrectomy.” Read article
