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Red cell distribution width is a novel biomarker that predicts excess body-mass index loss 1 year after laparoscopic Roux-en-Y gastric bypass

Abstract

Introduction

Bariatric surgery is the most effective method for producing sustained weight loss, improving obesity-associated comorbidities and reducing inflammation in the morbidly obese population. The red cell distribution width (RDW) is a novel marker of inflammation that is usually reported as part of a complete blood count. In this study, we tested our hypothesis that red cell distribution width might represent a novel biomarker predictive of excess body-mass index loss (EBMIL) following laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods

Five hundred and forty-seven LRYGB patients included from a single institution were individually reviewed, noting both preoperative RDW and percent excess BMI loss at 6 months and 1 year post-LRYGB (%EBMIL180 and %EBMIL365, respectively). Bivariate and multivariate linear regression analysis was conducted between age, gender, initial body-mass index (BMI0) and RDW and each of the two endpoints, to assess the independence of RDW as a predictor of postoperative success.

Results

The median RDW was 13.9 (13.3–14.6) %, and median EBMIL180 and EBMIL365 were 55.4 (45.2–66.7) % and 71.3 (58.9–87.8) %, respectively. After controlling for age, gender and BMI0, RDW was associated with %EBMIL365 (B = −1.4 [−2.8 to −0.002] %, P = .05), but not %EBMIL180 (B = −0.6 [−1.6 to 0.5] %, P = .30. Upon Kruskal–Wallis analysis, patients with a preoperative RDW > 15.0 % had significantly lower %EBMIL than those in the <13.0 % (P < .001) and 13.0–15.0 % (P < .01) strata.

Conclusions

RDW is predictive of EBMIL at 1 year following LRYGB. This represents a novel preoperative biomarker that may provide clinically useful prognostic information.

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Acknowledgments

The authors wish to thank Dr. Colleen Brophy, M.D., Professor of Surgery, Vanderbilt University as well as the Vanderbilt University Dept. of Biostatistics.

Funding

Vanderbilt RedCAP: CTSA Award UL1 TR000445 from NCATS/NIH.

Author information

Correspondence to Eric S. Wise.

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Disclosures

Eric Wise, Kyle Hocking, Adam Weltz, Anna Uebele, Jose Diaz, Stephen Kavic and Mark Kligman have no conflicts of interest to disclose.

Additional information

This manuscript will be presented as a poster at the 2016 Annual Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).

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Wise, E.S., Hocking, K.M., Weltz, A. et al. Red cell distribution width is a novel biomarker that predicts excess body-mass index loss 1 year after laparoscopic Roux-en-Y gastric bypass. Surg Endosc 30, 4607–4612 (2016). https://doi.org/10.1007/s00464-016-4798-9

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Keywords

  • Bariatrics
  • Biomarkers
  • Outcomes
  • Laparoscopy
  • Gastric bypass