Hormonal
High baseline insulin and/or glucose levels predict favorable treatment effects from bariatric surgery, whereas high baseline BMI does not.
Patients with high insulin or glucose levels, even if their BMI is not extremely high, may benefit significantly from bariatric surgery. This suggests that current BMI-based selection criteria might be too restrictive and that metabolic health should be a key factor in deciding who gets surgery.
Whereas high insulin and/or high glucose at baseline predicted favourable treatment effects, high baseline BMI did not, indicating that current selection criteria for bariatric surgery need to be revised.
Why this rating
Prospective study with subgroup analyses, but the finding is an interaction effect rather than a primary endpoint.
Source
Review of the key results from the Swedish Obese Subjects (<scp>SOS</scp>) trial – a prospective controlled intervention study of bariatric surgery
L. Sjöström · Journal of Internal Medicine · 2013
DOI 10.1111/joim.12012
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