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Prediction of Long-Term Diabetes Remission After Metabolic Surgery in Obese East Asian Patients: a Comparison Between ABCD and IMS Scores

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Abstract

Purpose

Recently, more than 10 models have been developed to predict remission of type 2 diabetes mellitus (T2DM) after metabolic surgery. The ABCD score was compared to the individualized metabolic surgery (IMS) score in terms of prediction of T2DM remission, but which of the two scoring systems is better remains controversial.

Methods

Patient data from 463 obese East Asian patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or SG with duodenojejunal bypass (SG-DJB) as a primary operation and were followed for at least 3 years were retrospectively collected from 24 institutions. The correlation between the ABCD and IMS scoring systems and the discrimination power of the models was evaluated. The cut-off point for the IMS stage of T2DM severity was also revised to adjust the scoring system to obese East Asian patients.

Results

The two scoring systems were significantly well correlated. The IMS scoring system showed significant differences in T2DM remission rates between the procedures in the moderate stage, but the ABCD score showed no significant differences in each category. The discrimination power of the IMS score was comparable to that of the ABCD score at both 3 and 5 years. The revised IMS scoring system showed that SG-DJB had significantly higher T2DM remission rates in the moderate stage at 5 years than RYGB or SG.

Conclusion

IMS score may be comparable to ABCD score to predict T2DM remission in obese East Asian patients. The revised IMS scoring system may also select candidates for SG or SG-DJB.

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References

  1. Shen SC, Wang W, Tam KW, et al. Validating risk prediction models of diabetes remission after sleeve gastrectomy. Obes Surg. 2019;29:221–9. https://doi.org/10.1007/s11695-018-3510-7.

    Article  PubMed  Google Scholar 

  2. Lee WJ, Hur K, Wong S, et al. Metabolic surgery ABCD score: predicting the success of surgical treatment diabetes. Obes Surg. 2013;23:1020.

    Article  Google Scholar 

  3. Lee WJ, Almulaifi A, Tsou JJ, et al. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score. Surg Obes Relat Dis. 2015;11:991–6. https://doi.org/10.1016/j.soard.2014.12.027.

    Article  PubMed  Google Scholar 

  4. Lee WJ, Chong K, Aung L, et al. Metabolic surgery for diabetes treatment: sleeve gastrectomy or gastric bypass? World J Surg. 2017;41:216–23. https://doi.org/10.1007/s00268-016-3690-z.

    Article  PubMed  Google Scholar 

  5. Aminian A, Brethauer SA, Andalib A, et al. Individualized metabolic surgery score: procedure selection based on diabetes surgery. Ann Surg. 2017;266:650–7. https://doi.org/10.1097/SLA.0000000000002407.

    Article  PubMed  Google Scholar 

  6. Chen JC, Hsu NY, Lee WJ, et al. Prediction of type 2 diabetes remission after metabolic surgery: a comparison of the individualized metabolic surgery score and the ABCD score. Surg Obes Relat Dis. 2018;14:640–5. https://doi.org/10.1016/j.soard.2018.01.027.

    Article  PubMed  Google Scholar 

  7. Still CD, Wood GC, Benotti P, et al. Preoperative prediction of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a retrospective cohort study. Lancet Diabetes Endocrinol. 2014;2:38–45. https://doi.org/10.1016/S2213-8587(13)70070-6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bhandai M, Fobi MAL, Buchwald JN, et al. Standardization of bariatric metabolic procedures: World Consensus Meeting Statement. Obes Surg. 2019;29(Suppl 4):309–45. https://doi.org/10.1007/s11695-019-04032-x.

    Article  Google Scholar 

  9. Seki Y, Kasama K, Haruta H, et al. Five-year-results of laparoscopic sleeve gastrectomy with duodenojejunal bypass for weight loss and type 2 diabetes mellitus. Obes Surg. 2017;27:795–801. https://doi.org/10.1007/s11695-016-2372-0.

    Article  PubMed  Google Scholar 

  10. Lee WJ, Lee KT, Kasama K, et al. Laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG); short-term result and comparison with gastric bypass. Obes Surg. 2014;24:109–13. https://doi.org/10.1007/s11695-013-1067-z.

    Article  PubMed  Google Scholar 

  11. Brethauer SA, Kim J, el Chaar M, et al. Standard outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11:489–506. https://doi.org/10.1016/j.soard.2015.02.003.

    Article  PubMed  Google Scholar 

  12. Naitoh T, Kasama M, Seki Y, et al. Efficacy of sleeve gastrectomywith duodenal-jejunal bypass for the treatment of obese severe diabetes patients in Japan: a retrospective multicenter study. Obes Surg. 2018;28:497–505. https://doi.org/10.1007/s11695-017-2874-4.

    Article  PubMed  Google Scholar 

  13. Ohta M, Seki Y, Park S, et al. Comparison between ABCD and IMS scores in the prediction of long-term T2DM remission after metabolic surgery in East Asian obese patients. J Metab Bariatr Surg. 2019;8:34–6. https://doi.org/10.1007/s11695-017-2874-4.

    Article  Google Scholar 

  14. Seki Y, Kasama K, Yasuda, et al. The effects of laparoscopic sleeve gastrectomy with duodenojejunal bypass on Japanese patients with BMI<35 kg/m2 on type 2 diabetes mellitus and the prediction of successful glycemic control. Obes Surg. 2018;28:2429–38. https://doi.org/10.1007/s11695-018-3179-y.

    Article  PubMed  Google Scholar 

  15. Lee WJ, Chong K, Lin YH, et al. Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect. Obes Surg. 2014;24:1552–62. https://doi.org/10.1007/s11695-014-1344-5.

    Article  PubMed  Google Scholar 

  16. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-years outcomes. N Engl J Med. 2017;376:641–51. https://doi.org/10.1056/NEJMoa1600869.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Zachariah PJ, Chen CY, Lee WJ, et al. Compared to sleeve gastrectomy, duodenal-jejunal bypass with sleeve gastrectomy gives better glycemic control in T2DM patients, with lower β-cell response and similar appetite sensations: mixed-meal study. Obes Surg. 2016;26:2862–72.

    Article  Google Scholar 

  18. Huang CK, Tai CM, Chang PC, et al. Loop duodenojejunal bypass with sleeve gastrectomy: comparative study with Roux-en-Y gastric bypass in type 2 diabetic patients with a BMI <35 kg/m2, first year results. Obes Surg. 2016;26:2291–301. https://doi.org/10.1007/s11695-016-2118-z.

    Article  PubMed  Google Scholar 

  19. Pessoa BM, Browning MG, Mazzini GS, et al. Factors mediating type 2 diabetes remission and relapse after gastric bypass surgery. J Am Coll Surg. 2020;230:7–16. https://doi.org/10.1016/j.jamcollsurg.2019.09.012.

    Article  PubMed  Google Scholar 

  20. Saiki A, Yamaguchi T, Tanaka S, et al. Background characteristics and postoperative outcomes of insufficient weight loss after laparoscopic sleeve gastrectomy in Japanese patients. Ann Gastroenterol Surg. 2019;3:638–47. https://doi.org/10.1002/ags3.12285.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Dixon JB, Lambert GW, Chuang LM, et al. Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes. Diabetes Care. 2013;36:20–6. https://doi.org/10.2337/dc12-0779.

    Article  CAS  PubMed  Google Scholar 

  22. Dixon JB, Hur KY, Lee WJ, et al. Gastric bypass in type 2 diabetes with BMI <30: weight and weight loss have major influence on outcome. Diabet Med. 2013;30:e127–34. https://doi.org/10.1111/dme.12107.

    Article  CAS  PubMed  Google Scholar 

  23. Park JY, Kim YJ. Prediction of diabetes remission in morbidly obese patients after Roux-en-Y gastric bypass. Obes Surg. 2016;26:749–56. https://doi.org/10.1007/s11695-015-1823-3.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Ms. Yuka Honda and Ayaka Noguchi for their assistance in the management of this study.

Author information

Authors and Affiliations

  1. Global Oita Medical Advanced Research Center for Health, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan

    Masayuki Ohta

  2. Departments of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan

    Masayuki Ohta

  3. Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan

    Yosuke Seki & Kazunori Kasama

  4. Biostatistics Center, Kurume University, Kurume, Japan

    Tetsuji Ohyama

  5. Department of General Surgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China

    Rixing Bai

  6. Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea

    Sang Hyun Kim

  7. Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan

    Takashi Oshiro

  8. Department of Hepatobiliary-Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Jilin, China

    Tao Jiang

  9. Department of Surgery, Iwate Medical University School of Medicine, Morioka, Japan

    Akira Sasaki

  10. Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan

    Takeshi Naitoh

  11. Department of Surgery, Shiga University of Medical Science, Otsu, Japan

    Tsuyoshi Yamaguchi

  12. Department of Surgery, Ohama Dai-ichi Hospital, Naha, Japan

    Susumu Inamine

  13. Department of Surgery, Osaka General Medical Center, Osaka, Japan

    Yasuhiro Miyazaki

  14. Department of Pediatric Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Soo Min Ahn

  15. Department of General Surgery, College of Medicine, Inha University, Incheon, South Korea

    Yoonseok Heo

  16. Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Hui Liang

  17. Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Seung Ho Choi

  18. Department of Metabolic and Bariatric Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China

    Wah Yang & Cunchuan Wang

  19. Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

    Qiyuan Yao

  20. Department of Surgery, Kansai Medical University, Hirakata, Japan

    Kentaro Inoue

  21. Kohnan Hospital, Koka, Japan

    Hiroshi Yamamoto

  22. Department of Surgery, Seoul National University Hospital, Seoul, South Korea

    Hyuk-Joon Lee

  23. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-Do, South Korea

    Young Suk Park

  24. Department of Surgery, Hanyang University College of Medicine, Seoul, South Korea

    Tae Kyung Ha

  25. Department of Surgery, Keimyung University School of Medicine, Daegu, South Korea

    Seung-Wan Ryu

  26. Department of Surgery, Korea University College of Medicine, Seoul, South Korea

    Sungsoo Park

Authors
  1. Masayuki Ohta
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  2. Yosuke Seki
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  3. Tetsuji Ohyama
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  4. Rixing Bai
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  5. Sang Hyun Kim
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  6. Takashi Oshiro
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  7. Tao Jiang
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  8. Akira Sasaki
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  9. Takeshi Naitoh
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  10. Tsuyoshi Yamaguchi
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  11. Susumu Inamine
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  12. Yasuhiro Miyazaki
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  13. Soo Min Ahn
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  14. Yoonseok Heo
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  15. Hui Liang
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  16. Seung Ho Choi
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  20. Hiroshi Yamamoto
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  21. Hyuk-Joon Lee
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  22. Young Suk Park
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  23. Tae Kyung Ha
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  24. Seung-Wan Ryu
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  25. Cunchuan Wang
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  26. Sungsoo Park
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  27. Kazunori Kasama
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Corresponding author

Correspondence to Masayuki Ohta.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Standard of Informed Consent

The study has been approved by the Ethics Committee of Oita University Faculty of Medicine, and the informed consent was obtained by the opt-out method, because this study was retrospective and anonymized, and included the data of many former patients.

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Ohta, M., Seki, Y., Ohyama, T. et al. Prediction of Long-Term Diabetes Remission After Metabolic Surgery in Obese East Asian Patients: a Comparison Between ABCD and IMS Scores. OBES SURG 31, 1485–1495 (2021). https://doi.org/10.1007/s11695-020-05151-6

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  • DOI: https://doi.org/10.1007/s11695-020-05151-6

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