Construction of a prediction model for the improvement of metabolic syndrome after metabolic and bariatric surgery: A cohort study

构建代谢和减肥手术后代谢综合征改善的预测模型:一项队列研究

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Abstract

The prevalence of metabolic syndrome (MetS) has emerged as a serious public health issue. The application of metabolic and bariatric surgery (MBS) for the treatment of MetS has been increasingly recognized. However, there are few reports on the influencing factors of MetS remission in patients after surgery. This study analyzed 184 patients with concomitant MetS who underwent laparoscopic sleeve gastrectomy. Patients were followed up for 1-year post operation. Utilizing a 7:3 ratio, patients were split into 2 groups at random: derivation cohort (n = 129) and validation cohort (n = 55). Univariate and multivariate logistic regression analyses were conducted to determine the variables impacting MetS remission. Subsequently, establishing a prediction model. An online nomogram was developed to visualize the model. Logistic regression analysis revealed that diabetes, body mass index, hypertension, triglyceride, obesity time, and fasting blood glucose were independent factors affecting the remission of MetS. These factors were integrated into the prediction model and represented visually through a nomogram. The area under the receiver operating characteristic curve for derivation and validation cohorts was 0.941 (95% CI = 0.894-0.988) and 0.915 (95% CI = 0.894-0.988), respectively. The calibration curve showed a good concordance between the expected and observed findings, and the Hosmer-Lemeshow test evaluated the model's accuracy (P = .254, .315). Decision curve analysis demonstrated favorable net benefits conferred by the model. MBS can improve MetS, and the nomogram established in this study holds promise for predicting the remission of MetS in patients with obesity following MBS.

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