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What Is the Best Method for Diagnosing Osteosarcopenic Adiposity in Women After Long-Term Bariatric Surgery? A Comparison and Validation of Different Criteria

  • 0Graduate Program in Human Nutrition, University of Brasilia, Brasília 70910-900, Brazil.
Nutrients +

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November 27, 2024

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November 27, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

The Kelly criterion showed the highest accuracy for diagnosing osteosarcopenic adiposity (OSAd) in women after Roux-en-Y gastric bypass (RYGB) surgery. However, all tested criteria had low sensitivity, indicating a need for improved diagnostic methods.

Area Of Science

  • Endocrinology
  • Bariatric Surgery Outcomes
  • Metabolic Health

Background

  • Osteosarcopenic adiposity (OSAd) is a concern in post-bariatric surgery patients.
  • Roux-en-Y gastric bypass (RYGB) significantly alters body composition and metabolic health.
  • Accurate diagnosis of OSAd is crucial for managing long-term health after RYGB.

Purpose Of The Study

  • To compare the diagnostic agreement and discriminant validity of different OSAd criteria in women post-RYGB.
  • To assess the prevalence of OSAd using various diagnostic approaches.
  • To identify the most accurate criterion for OSAd detection in this specific population.

Main Methods

  • Cross-sectional study involving 178 women at least 2 years post-RYGB.
  • Evaluated three OSAd diagnostic criteria: Kelly, ESPEN/EASO, and SDOC, combined with WHO osteopenia criteria.
  • Assessed agreement using Cohen's Kappa and discriminatory capability via sensitivity, specificity, and accuracy against physical function and fracture risk.

Main Results

  • Prevalence of OSAd varied: 2.2% (Kelly), 2.8% (ESPEN/EASO + WHO), and 6.2% (SDOC + WHO).
  • Kelly and ESPEN/EASO criteria showed moderate agreement (k=0.658), while Kelly and SDOC had null agreement (k=0.104).
  • All criteria demonstrated high specificity (94.0-98.2%) but low sensitivity (0.0-16.7%), with Kelly achieving the highest accuracy (92.7%).

Conclusions

  • The Kelly criterion is the most accurate for OSAd diagnosis in post-RYGB women, identifying 2.2% prevalence.
  • Existing diagnostic criteria for OSAd exhibit high specificity but critically low sensitivity in this population.
  • There is an urgent need for developing more sensitive diagnostic tools for OSAd in women following RYGB surgery.

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