PMID- 34255166
OWN - NLM
STAT- MEDLINE
DCOM- 20220217
LR  - 20220813
IS  - 1435-2451 (Electronic)
IS  - 1435-2443 (Print)
IS  - 1435-2443 (Linking)
VI  - 407
IP  - 1
DP  - 2022 Feb
TI  - External validation of predictive scores for diabetes remission after metabolic 
      surgery.
PG  - 131-141
LID - 10.1007/s00423-021-02260-3 [doi]
AB  - PURPOSE: Bariatric surgery has proven to be the most efficient treatment for 
      obesity and type 2 diabetes mellitus (T2DM). Despite detailed qualification, 
      desirable outcome after an intervention is not achieved by every patient. Various 
      risk prediction models of diabetes remission after metabolic surgery have been 
      established to facilitate the decision-making process. The purpose of the study 
      is to validate the performance of available risk prediction scores for diabetes 
      remission a year after surgical treatment and to determine the optimal model. 
      METHODS: A retrospective analysis comprised 252 patients who underwent Roux-en-Y 
      gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2009 and 2017 and 
      completed 1-year follow-up. The literature review revealed 5 models, which were 
      subsequently explored in our study. Each score relationship with diabetes 
      remission was assessed using logistic regression. Discrimination was evaluated by 
      area under the receiver operating characteristic (AUROC) curve, whereas 
      calibration by the Hosmer-Lemeshow test and predicted versus observed remission 
      ratio. RESULTS: One year after surgery, 68.7% partial and 21.8% complete diabetes 
      remission and 53.4% excessive weight loss were observed. DiaBetter demonstrated 
      the best predictive performance (AUROC 0.81; 95% confidence interval (CI) 
      0.71-0.90; p-value > 0.05 in the Hosmer-Lemeshow test; predicted-to-observed 
      ratio 1.09). The majority of models showed acceptable discrimination power. In 
      calibration, only the DiaBetter score did not lose goodness-of-fit in all 
      analyzed groups. CONCLUSION: The DiaBetter score seems to be the most appropriate 
      tool to predict diabetes remission after metabolic surgery since it presents 
      adequate accuracy and is convenient to use in clinical practice. There are no 
      accurate models to predict T2DM remission in a patient with advanced diabetes.
CI  - (c) 2021. The Author(s).
FAU - Karpinska, Izabela A
AU  - Karpinska IA
AD  - 2nd Department of General Surgery, Jagiellonian University Medical College, 
      Jakubowskiego 2 st., 30-688, Krakow, Poland.
FAU - Choma, Joanna
AU  - Choma J
AD  - 2nd Department of General Surgery, Jagiellonian University Medical College, 
      Jakubowskiego 2 st., 30-688, Krakow, Poland.
FAU - Wysocki, Michal
AU  - Wysocki M
AD  - Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial 
      Hospital in Cracow, Krakow, Poland.
FAU - Dudek, Alicja
AU  - Dudek A
AD  - 2nd Department of General Surgery, Jagiellonian University Medical College, 
      Jakubowskiego 2 st., 30-688, Krakow, Poland.
FAU - Malczak, Piotr
AU  - Malczak P
AD  - 2nd Department of General Surgery, Jagiellonian University Medical College, 
      Jakubowskiego 2 st., 30-688, Krakow, Poland.
AD  - Krakow University Hospital, Krakow, Poland.
AD  - Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), 
      Krakow, Poland.
FAU - Szopa, Magdalena
AU  - Szopa M
AD  - Krakow University Hospital, Krakow, Poland.
AD  - Department of Metabolic Diseases, Jagiellonian University Medical College, 
      Krakow, Poland.
FAU - Pedziwiatr, Michal
AU  - Pedziwiatr M
AD  - 2nd Department of General Surgery, Jagiellonian University Medical College, 
      Jakubowskiego 2 st., 30-688, Krakow, Poland.
AD  - Krakow University Hospital, Krakow, Poland.
AD  - Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), 
      Krakow, Poland.
FAU - Major, Piotr
AU  - Major P
AUID- ORCID: 0000-0001-6552-7979
AD  - 2nd Department of General Surgery, Jagiellonian University Medical College, 
      Jakubowskiego 2 st., 30-688, Krakow, Poland. piotr.major@uj.edu.pl.
AD  - Krakow University Hospital, Krakow, Poland. piotr.major@uj.edu.pl.
AD  - Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), 
      Krakow, Poland. piotr.major@uj.edu.pl.
LA  - eng
PT  - Journal Article
DEP - 20210713
PL  - Germany
TA  - Langenbecks Arch Surg
JT  - Langenbeck's archives of surgery
JID - 9808285
SB  - IM
MH  - *Bariatric Surgery
MH  - *Diabetes Mellitus, Type 2/surgery
MH  - Gastrectomy
MH  - *Gastric Bypass
MH  - Humans
MH  - *Obesity, Morbid/surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC8847237
OTO - NOTNLM
OT  - Bariatric surgery
OT  - Diabetes remission
OT  - External validation
OT  - Metabolic surgery
OT  - Risk prediction scores
OT  - Type 2 diabetes mellitus
COIS- The authors declare no competing interests.
EDAT- 2021/07/14 06:00
MHDA- 2022/02/19 06:00
PMCR- 2021/07/13
CRDT- 2021/07/13 12:25
PHST- 2021/04/10 00:00 [received]
PHST- 2021/06/28 00:00 [accepted]
PHST- 2021/07/14 06:00 [pubmed]
PHST- 2022/02/19 06:00 [medline]
PHST- 2021/07/13 12:25 [entrez]
PHST- 2021/07/13 00:00 [pmc-release]
AID - 10.1007/s00423-021-02260-3 [pii]
AID - 2260 [pii]
AID - 10.1007/s00423-021-02260-3 [doi]
PST - ppublish
SO  - Langenbecks Arch Surg. 2022 Feb;407(1):131-141. doi: 10.1007/s00423-021-02260-3. 
      Epub 2021 Jul 13.