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ASSOCIATION OF GLP-1 AGONIST USE WITH SLEEVE GASTRECTOMY OUTCOMES: A RETROSPECTIVE COHORT STUDY
Simranjeet K. Sidhu, BS1*, Hee-Jung J. Kim, BS1*, Katharine P. Playter, BS1, Zachary Ballinger, MD2, Hayley Reddington, MD2, Richard Perugini, MD2 *These authors contributed equally. 1University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA 2Department of Surgery, University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA
Background: We examined the relationship between timing and duration of GLP-1 agonist use and outcomes following sleeve gastrectomy (SG). Methods: We conducted a retrospective cohort study of SG at a metropolitan tertiary care center (January 2020-December 2023). GLP-1RA usage within 1 year of surgery was required for GLP-1RA group inclusion. Subgroups were analyzed by timing of use (preoperative/postoperative/both) and duration-of-use quartiles. Evaluated outcomes included percent excess body weight loss (%EBWL), percent total weight loss (%WL), and hemoglobin A1C (HbA1c) change. Statistical analysis used two-sample t-test, ANOVA, and Chi-square test of independence. Results: Among 1380 patients, 178 (12.95%) used GLP-1RAs within 1 year of SG. GLP-1RAs were more likely to be used by individuals who were older, male, and had pre-existing type 2 diabetes mellitus. Patients not receiving GLP-1RAs achieved significantly greater %WL postoperatively than patients that used GLP-1RAs. Preoperative GLP-1RA use was associated with a greater %EBWL (60.22%; SD=24.68) at 1 year postoperatively than postoperative use alone (49.86%; SD=17.48) and use during both periods (46.13%; SD=22.68)(p<0.001). Longer GLP-1RA use was associated with decreased %EBWL and %WL 1 year postoperatively. Conclusion: GLP-1 agonist use was associated with reduced weight loss following SG. GLP-1RAs may help patients with suboptimal outcomes, though optimal administration warrants further research.
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