Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity.

BACKGROUND: Differences in the preoperative characteristics and weight loss outcomes after sleeve gastrectomy (SG) between patients with familial aggregation of obesity (FAO) and patients with sporadic obesity (SO) have not been elucidated.

AIM: To explore the impact of SG on weight loss and the alleviation of obesity-related comorbidities in individuals with FAO.

METHODS: A total of 193 patients with obesity who underwent SG were selected. Patients with FAO/SO were matched 1:1 by propensity score matching and were categorized into 4 groups based on the number of first-degree relatives with obesity (1 SO vs 1 FAO, 2 SO vs 2 FAO). The baseline characteristics, weight loss outcomes, prevalence of obesity-related comorbidities and incidence of major surgery-related complications were compared between groups.

RESULTS: We defined FAO as the presence of two or more first-degree relatives with obesity. Patients with FAO did not initially show significant differences in baseline data, short-term postoperative weight loss, or obesity-related comorbidities when compared to patients with SO preoperatively. However, distinctions between the two groups became evident at the two-year mark, with statistically significant differences in both percentage of total weight loss ( P = 0.006) and percentage of excess weight loss ( P < 0.001). The FAO group exhibited weaker remission of type 2 diabetes mellitus (T2DM) ( P = 0.031), hyperlipidemia ( P = 0.012), and non-alcoholic fatty liver disease (NAFLD) ( P = 0.003) as well as a lower incidence of acid reflux ( P = 0.038).

CONCLUSION: FAO patients is associated with decreased mid-to-long-term weight loss outcomes; the alleviation of T2DM, hyperlipidemia and NAFLD; and decreased incidence of acid reflux postoperatively.