adeb18cb9a89dc91ac61abb883a05a0c pmc_11396150.pdf a12a129c895229c5c7563957d720aaa5179af7a0 pmc_11396150.pdf 6907c61dc8efaf2f259f313ca927b3145fae01d3ede267a564ad281743bdd4bb pmc_11396150.pdf Title: Pre-Surgery Cortisol Levels as Biomarker of Evolution after Bariatric Surgery: Weight Loss and Weight Regain Subject: Background: Bariatric surgery (BS) is effective for achieving significant weight loss. However, weight regain (WR) is an emerging problem. Objective: To assess the prognostic value of morning serum cortisol, a 1 mg dexamethasone suppression test (DST), 24 h urinary free cortisol (UFC) and late-night salivary cortisol (LNSC) in a cohort of patients with severe obesity (pwSO) undergoing BS in terms of weight loss and WR. Methods: Patients scheduled for BS underwent the following procedures at baseline, 12 months and 24 months after BS: medical history, anthropometric data, blood analysis and cortisol tests. We evaluated total weight loss (TWL) 30% at 1 year and WR after 2 years as an increase of 10% of the maximum weight lost. Results: In total, 142 subjects were included; 101 (71.1%) were females and the mean age was 45.9 9.2 years. Up to 76.8% of subjects achieved 30% TWL, without statistically significant differences in DST results or morning serum cortisol, UFC or LNSC levels. However, a higher pre-surgery morning serum cortisol level was a significant predictor of a WR 10% (cortisol 17.8 [IQR 13.1–18.5] vs. 12.0 [IQR 8.8–15.8] g/dL; p < 0.01); OR of 1.216 (95% CI 1.069–1.384); AUC [0.761, CI: (0.616–0.906); p < 0.01]. A cut-off value of cortisol > 13.0 g/dL was predictive of a WR 10% (sensitivity 0.71; specificity 0.63). Conclusions: No cortisol test was useful in predicting weight loss; however, the pre-surgery morning serum cortisol level was able to predict a WR 10% in a cohort of pwSO 2 years after BS. A cut-off value of cortisol > 13 g/dL might be an easy tool to identify patients at higher risk of WR, enabling healthcare providers to implement tailored, long-term strategies to minimize this outcome. Keywords: dexamethasone suppression test; DST 1 mg; morning serum cortisol; bariatric surgery; weight regain; weight loss; severe obesity Author: Anna Casteràs, Enzamaria Fidilio, Marta Comas, Alba Zabalegui, Vanesa Flores, Marina Giralt, Noelia Díaz-Troyano, Roser Ferrer, Ramon Vilallonga, Andreea Ciudin and Betina Biagetti Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Sep 3 10:42:39 2024 CEST ModDate: Tue Sep 3 10:45:16 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1057303 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- PYPZKK+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 BVROXL+EURM10 Type 1 Builtin yes yes yes 16 0 WGZZQG+URWPalladioL-Bold Type 1 Custom yes yes yes 21 0 AAULKY+URWPalladioL-Roma Type 1 Custom yes yes yes 27 0 EEQRGE+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 CZMDWU+CMSY10 Type 1 Builtin yes yes yes 37 0 KORLVE+VnURWPalladioL Type 1 Custom yes yes yes 42 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 58 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 61 0 FINPKM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 97 0 FINPKN+PalatinoLinotype CID TrueType Identity-H yes yes yes 100 0 FINPKO+PalatinoLinotype TrueType WinAnsi yes yes no 106 0 FINPLA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 109 0 FIOAGM+PalatinoLinotype TrueType MacRoman yes yes no 112 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 120 0 FINPKM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 132 0 FINPKN+PalatinoLinotype CID TrueType Identity-H yes yes yes 135 0 FINPKO+PalatinoLinotype TrueType WinAnsi yes yes no 141 0 FINPLA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 144 0 FIOAGM+PalatinoLinotype TrueType MacRoman yes yes no 147 0 FINPKM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 162 0 FINPKN+PalatinoLinotype CID TrueType Identity-H yes yes yes 165 0 FINPKO+PalatinoLinotype TrueType WinAnsi yes yes no 171 0 FINPLA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 174 0 FIOAGM+PalatinoLinotype TrueType MacRoman yes yes no 177 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-02-06 02:48:30 CET RepresentationInformation: pmc_11396150.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-01-18 02:37:16 CET Size: 1057303 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 389 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Pre-Surgery Cortisol Levels as Biomarker of Evolution after Bariatric Surgery: Weight Loss and Weight Regain Author: Anna Casteràs, Enzamaria Fidilio, Marta Comas, Alba Zabalegui, Vanesa Flores, Marina Giralt, Noelia Díaz-Troyano, Roser Ferrer, Ramon Vilallonga, Andreea Ciudin and Betina Biagetti Subject: Background: Bariatric surgery (BS) is effective for achieving significant weight loss. However, weight regain (WR) is an emerging problem. Objective: To assess the prognostic value of morning serum cortisol, a 1 mg dexamethasone suppression test (DST), 24 h urinary free cortisol (UFC) and late-night salivary cortisol (LNSC) in a cohort of patients with severe obesity (pwSO) undergoing BS in terms of weight loss and WR. Methods: Patients scheduled for BS underwent the following procedures at baseline, 12 months and 24 months after BS: medical history, anthropometric data, blood analysis and cortisol tests. We evaluated total weight loss (TWL) 30% at 1 year and WR after 2 years as an increase of 10% of the maximum weight lost. Results: In total, 142 subjects were included; 101 (71.1%) were females and the mean age was 45.9 9.2 years. Up to 76.8% of subjects achieved 30% TWL, without statistically significant differences in DST results or morning serum cortisol, UFC or LNSC levels. However, a higher pre-surgery morning serum cortisol level was a significant predictor of a WR 10% (cortisol 17.8 [IQR 13.1 18.5] vs. 12.0 [IQR 8.8 15.8] g/dL; p < 0.01); OR of 1.216 (95% CI 1.069 1.384); AUC [0.761, CI: (0.616 0.906); p < 0.01]. A cut-off value of cortisol > 13.0 g/dL was predictive of a WR 10% (sensitivity 0.71; specificity 0.63). Conclusions: No cortisol test was useful in predicting weight loss; however, the pre-surgery morning serum cortisol level was able to predict a WR 10% in a cohort of pwSO 2 years after BS. A cut-off value of cortisol > 13 g/dL might be an easy tool to identify patients at higher risk of WR, enabling healthcare providers to implement tailored, long-term strategies to minimize this outcome. 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