Clinical efficacy and prognostic analysis of laparoscopic sleeve gastrectomy in the treatment of obesity complicated with albuminuria

Objective To investigate the clinical efficacy and prognostic influencing factor of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity complicated with albuminuria.

Methods The retrospective cohort study was conducted. The clinical data of 80 obesity patients with albuminuria who underwent LSG at Huashan Hospital Affiliated to Fudan University from January 2020 to December 2023 were collected. There were 24 males and 56 females, aged 33(28,38) years. The body mass index of patients was 41(37,44) kg/m². Observation indicators: (1) follow-up; (2) analysis of influencing factors for the remission of albuminuria after LSG. Comparison of measurement data with normal distribution between groups was conducted using the independent samples t test. Comparison of measurement data with skewed distribution was conducted using the Mann-Whitney U nonparametric test. Comparison of count data between groups was conducted using the chi-square test. For univariate analysis, the corresponding statistical methods were selected according to data types. Multivariate analysis was analyzed using the Logistic regression model. Univariate factors with P<0.10 were included in the multivariate analysis.

Results (1) Follow-up: all 80 patients were followed up for 6 months after LSG. During the follow-up, among the 69 patients with preoperative microalbuminuria, 49 cases achieved remission after surgery. Among the 11 patients with preoperative macroalbuminuria, 1 case achieved postoperative remission. The overall post-operative albuminuria remission rate was 62.5%(50/80). The percentage of total body weight loss was 25%±5%, and the percentage of excess body weight loss was 68%±26%. (2) Analysis of influen-cing factors for albuminuria remission after LSG: results of multivariate analysis showed that the urinary albumin-to-creatinine ratio (UACR) was an independent influencing factor for albuminuria remission in obesity patients with albuminuria after LSG (odds ratio=0.992, 95% confidence interval as 0.987-0.997, P<0.05).

Conclusions LSG has a favorable clinical efficacy in the treatment of obesity complicated with albuminuria and can effectively promote the remission of albuminuria. Preoperative UACR is an independent influencing factor for the remission of albuminuria in obesity patients with albuminuria after LSG.