Pre-Surgery Cortisol Levels as Biomarker of Evolution after Bariatric Surgery : Weight Loss and Weight Regain
Casteràs, Anna (Universitat Autònoma de Barcelona. Departament de Medicina)
Fidilio, Enzamaria (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Comas Martínez, Marta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Zabalegui Eguinoa, Alba (Hospital Universitari Vall d'Hebron)
Flores, Vanesa (Hospital Universitari Vall d'Hebron)
Giralt Arnaiz, Marina (Hospital Universitari Vall d'Hebron)
Díaz-Troyano, Noelia (Hospital Universitari Vall d'Hebron)
Ferrer Costa, Roser (Universitat Autònoma de Barcelona. Departament de Medicina)
Vilallonga, Ramon (Universitat Autònoma de Barcelona. Departament de Medicina)
Ciudin, Andreea (Universitat Autònoma de Barcelona. Departament de Medicina)
Biagetti, Betina (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2024
Resum:	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] μg/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 μg/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 μg/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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Dexamethasone suppression test ; DST 1 mg ; Morning serum cortisol ; Bariatric surgery ; Weight regain ; Weight loss ; Severe obesity
Publicat a:	Journal of clinical medicine, Vol. 13 (august 2024) , ISSN 2077-0383

DOI: 10.3390/jcm13175146
PMID: 39274358

13 p, 1.0 MB

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