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Obesity Surgery

, Volume 29, Issue 1, pp 221–229 | Cite as

Validating Risk Prediction Models of Diabetes Remission After Sleeve Gastrectomy

  • Shih-Chiang Shen
  • Weu Wang
  • Ka-Wai Tam
  • Hsin-An Chen
  • Yen-Kuang Lin
  • Shih-Yun Wang
  • Ming-Te Huang
  • Yen-Hao SuEmail author
Original Contributions

Abstract

Introduction

Many risk prediction models of diabetes remission after bariatric and metabolic surgery have been proposed. Most models have been created using Roux-en-Y gastric bypass cohorts. However, validation of these models in sleeve gastrectomy (SG) is limited. The objective of our study is to validate the performance of risk prediction models of diabetes remission in obese patients with diabetes who underwent SG.

Method

This retrospective cohort study included 128 patients who underwent SG with at least 1 year follow-up from Dec 2011 to Sep 2016 as the validation cohort. A literature review revealed total 11 models with 2 categories (scoring system and logistic regression), which were validated by our study dataset. Discrimination was evaluated by area under the receiver operating characteristic (AUC) while calibration by Hosmer–Lemeshow test and predicted versus observed remission ratio.

Results

At 1 year after surgery, 71.9% diabetes remission (HbA1c < 6.0 off medication) and 61.4% excess weight loss were observed. Individual metabolic surgery, ABCD, DiaRem, Advanced-DiaRem, DiaBetter, Ana et al., and Dixon et al. models showed excellent discrimination power (AUC > 0.8). In calibration, all models overestimated diabetes remission from 5 to 30% but did not lose their goodness of fit.

Conclusion

This is the first comprehensive external validation of current risk prediction models of diabetes remission at 1 year after SG. Seven models showed excellent predicting power, and scoring models were recommended more because of their easy utility.

Keywords

Diabetes remission Risk prediction models External validation Sleeve gastrectomy Bariatric surgery Metabolic surgery 

Notes

Acknowledgements

This manuscript was edited by Wallace Academic Editing.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

11695_2018_3510_MOESM1_ESM.docx (139 kb)
ESM 1 (DOCX 139 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of General Surgery, Department of SurgeryShuang Ho Hospital, Taipei Medical UniversityNew Taipei CityTaiwan
  2. 2.Department of Surgery, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  3. 3.Division of General Surgery, Department of SurgeryTaipei Medical University HospitalTaipeiTaiwan
  4. 4.Cochrane TaiwanTaipei Medical UniversityTaipeiTaiwan
  5. 5.Research Center of BiostatisticsTaipei Medical UniversityTaipeiTaiwan
  6. 6.School of Nursing, College of NursingTaipei Medical UniversityTaipeiTaiwan
  7. 7.Metabolic and Weight Management Center, Shuang Ho HospitalTaipei Medical UniversityNew Taipei CityTaiwan

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