SpringerLink
Log in

Comparison of the ABCD Score's Accuracy in Predicting Remission of Type 2 Diabetes Mellitus One Year After Sleeve Gastrectomy, One Anastomosis Gastric Bypass, and Sleeve Gastrectomy with Transit Bipartition

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Purpose

ABCD score is one of the scoring systems that predicts the probability of T2DM remission after bariatric surgery. Its success in determining T2DM remission after sleeve gastrectomy with transit bipartition (TB) has not yet been validated. The aim of this study was to evaluate the predictive value of ABCD score in TB.

Materials and Methods

Of 438 patients with T2DM, 191 underwent sleeve gastrectomy (SG), 136 underwent one anastomosis gastric bypass (OAGB), and 111 underwent TB. Retrospective analysis of ABCD scores, 1-year postoperative remission rates, and the predictive accuracy of ABCD scores for these were conducted.

Results

In the SG, OAGB, and TB groups, respectively, median ABCD scores were 7, 6, and 4, while complete remission rates were 95.3%, 84.6%, and 76.6% (p < 0.001). The area under curves (AUCs) for SG, OAGB, and TB were 0.829 (95% CI = 0.768 to 0.879, p < 0.0001), 0.801 (95% CI = 0.724 to 0.865, p < 0.0001), and 0.840 (95% CI = 0.758 to 0.902, p < 0.0001), respectively. There was no statistically significant difference between AUCs.

Conclusion

ABCD score predicts the probability of remission at 1-year follow-up in T2DM patients undergoing TB as accurately as in patients receiving SG or OAGB.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289:76–9. https://doi.org/10.1001/jama.289.1.76.

    Article  PubMed  Google Scholar 

  2. Christou GA, Kiortsis DN. Adiponectin and lipoprotein metabolism. Obes Rev. 2013;14:939–49. https://doi.org/10.1111/obr.12064.

    Article  CAS  PubMed  Google Scholar 

  3. Santoro S, Castro LC, Velhote MC, Malzoni CE, Klajner S, Castro LP, Lacombe A, Santo MA. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg. 2012;256:104–10. https://doi.org/10.1097/SLA.0b013e31825370c0.

    Article  PubMed  Google Scholar 

  4. Plaeke P, Beunis A, Ruppert M, De Man JG, De Winter BY, Hubens G. Review, Performance Comparison, and Validation of Models Predicting Type 2 Diabetes Remission After Bariatric Surgery in a Western European Population. Obes Surg. 2021;31:1549–60. https://doi.org/10.1007/s11695-020-05157-0.

    Article  PubMed  Google Scholar 

  5. Ohta M, Seki Y, Ohyama T, Bai R, Kim SH, Oshiro T, Jiang T, Sasaki A, Naitoh T, Yamaguchi T, Inamine S, Miyazaki Y, Ahn SM, Heo Y, Liang H, Choi SH, Yang W, Yao Q, Inoue K, Yamamoto H, Lee HJ, Park YS, Ha TK, Ryu SW, Wang C, Park S, Kasama K. Prediction of Long-Term Diabetes Remission After Metabolic Surgery in Obese East Asian Patients: a Comparison Between ABCD and IMS Scores. Obes Surg. 2021;31:1485–95. https://doi.org/10.1007/s11695-020-05151-6.

    Article  PubMed  Google Scholar 

  6. Aminian A, Brethauer SA, Andalib A, Nowacki AS, Jimenez A, Corcelles R, Hanipah ZN, Punchai S, Bhatt DL, Kashyap SR, Burguera B, Lacy AM, Vidal J, Schauer PR. Individualized metabolic surgery score: procedure selection based on diabetes severity. Ann Surg. 2017;266:650–7. https://doi.org/10.1097/SLA.0000000000002407.

    Article  PubMed  Google Scholar 

  7. Sampaio-Neto J, Nassif LS, Branco-Filho AJ, Bolfarini LA, Loro LS, de Souza MP, Bianco T. External validation of the DiaRem score as a remission predictor of diabetes mellitus type 2 in obese patients undergoing Roux-en-Y gastric bypass. Arq Bras Cir Dig. 2015;28(Suppl 1):19–22. https://doi.org/10.1590/S0102-6720201500S100007.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Eskandaros MS, Abbass A, Ebeid EF, Darwish AA. Remission of type II diabetes mellitus 1-year postoperative following one anastomosis gastric bypass in correlation with ABCD, DiaRem, and DRS scores. Obes Surg. 2022;32:450–6. https://doi.org/10.1007/s11695-021-05793-0.

    Article  PubMed  Google Scholar 

  9. Lee WJ, Almulaifi A, Tsou JJ, Ser KH, Lee YC, Chen SC. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score. Surg Obes Relat Dis. 2015;11:991–6. https://doi.org/10.1016/j.soard.2014.12.027.

    Article  PubMed  Google Scholar 

  10. Brethauer SA, Kim J, el Chaar M, Papasavas P, Eisenberg D, Rogers A, Ballem N, Kligman M, Kothari S, ASMBS Clinical Issues Committee. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg Springer, New York LLC. 2015;25:587–606. https://doi.org/10.1007/s11695-015-1645-3.

    Article  Google Scholar 

  11. Shen SC, Wang W, Tam KW, Chen HA, Lin YK, Wang SY, Huang MT, Su YH. Validating risk prediction models of diabetes remission after sleeve gastrectomy. Obes Surg. 2019;29:221–9. https://doi.org/10.1007/s11695-018-3510-7.

    Article  PubMed  Google Scholar 

  12. Kodama S, Fujihara K, Horikawa C, Harada M, Ishigoro H, Kaneko M, et al. Network meta-analysis of the relative efficacy of bariatric surgeries for diabetes remission. Obes Rev. 2018;19:1621–9. https://doi.org/10.1111/obr.12751.

    Article  CAS  PubMed  Google Scholar 

  13. Lee WJ, Chong K, Chen SC, Zachariah J, Ser KH, Lee YC, Chen JC. Preoperative prediction of type 2 diabetes remission after gastric bypass surgery: a comparison of DiaRem scores and ABCD scores. Obes Surg. 2016;26:2418–24. https://doi.org/10.1007/s11695-016-2120-5.

    Article  PubMed  Google Scholar 

  14. Ha J, Kwon Y, Kim NH, Park S, Menzo EL, Rosenthal RJ. Discordance in prediction for prognosis of type 2 diabetes after metabolic surgery: comparison of the ABCD, DiaRem, and individualized metabolic surgery models. Ann Surg Treat Res. 2019;97:309–18. https://doi.org/10.4174/astr.2019.97.6.309.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Calisir A, Ece I, Yilmaz H, Alptekin H, Acar F, Yormaz S, Colak B, Sahin M. The mid-term effects of transit bipartition with sleeve gastrectomy on glycemic control, weight loss, and nutritional status in patients with type 2 diabetes mellitus: a retrospective analysis of a 3-year follow-up. Obes Surg. 2021;31:4724–33. https://doi.org/10.1007/s11695-021-05536-1.

    Article  PubMed  Google Scholar 

  16. Karaca FC. Effects of sleeve gastrectomy with transit bipartition on glycemic variables, lipid profile, liver enzymes, and nutritional status in type 2 diabetes mellitus patients. Obes Surg. 2020;30:1437–45. https://doi.org/10.1007/s11695-019-04326-0.

    Article  PubMed  Google Scholar 

  17. Al M, Taskin HE. Sleeve gastrectomy with transit bipartition in a series of 883 patients with mild obesity: early effectiveness and safety outcomes. Surg Endosc. 2022;36:2631–42. https://doi.org/10.1007/s00464-021-08769-4.

    Article  PubMed  Google Scholar 

  18. Ahuja A, Tantia O, Chaudhuri T, Khanna S, Seetharamaiah S, Majumdar K, Goyal G. Predicting remission of diabetes post metabolic surgery: a comparison of ABCD, diarem, and DRS scores. Obes Surg. 2018;28:2025–31. https://doi.org/10.1007/s11695-018-3136-9.

    Article  PubMed  Google Scholar 

  19. Targher G, Corey KE, Byrne CD, Roden M. The complex link between NAFLD and type 2 diabetes mellitus — mechanisms and treatments. Nat Rev Gastroenterol Hepatol. 2021;18:599–612. https://doi.org/10.1038/s41575-021-00448-y.

    Article  PubMed  Google Scholar 

  20. Wieckowska A, McCullough AJ, Feldstein AE. Noninvasive diagnosis and monitoring of nonalcoholic steatohepatitis: present and future. Hepatology. 2007;46:582–9. https://doi.org/10.1002/hep.21768.

    Article  CAS  PubMed  Google Scholar 

  21. Mofrad P, Contos MJ, Haque M, Sargeant C, Fisher RA, Luketic VA, Sterling RK, Shiffman ML, Stravitz RT, Sanyal AJ. Clinical and histologic spectrum of nonalcoholic fatty liver disease associ-ated with normal ALT values. Hepatology. 2003;37:1286–92. https://doi.org/10.1053/jhep.2003.50229.

    Article  PubMed  Google Scholar 

  22. Kunde SS, Lazenby AJ, Clements RH, Abrams GA. Spectrum of NAFLD and diagnostic implications of the proposed new normal range for serum ALT in obese women. Hepatology. 2005;42:650–6. https://doi.org/10.1002/hep.20818.

    Article  PubMed  Google Scholar 

  23. Zghebi SS, Mamas MA, Ashcroft DM, Rutter MK, VanMarwijk H, Salisbury C, Mallen CD, Chew-Graham CA, Qureshi N, Weng SF, Holt T, Buchan I, Peek N, Giles S, Reeves D, Kontopantelis E. Development and validation of the DIabetes Severity SCOre (DISSCO) in 139 626 individuals with type 2 diabetes: a retrospective cohort study. BMJ Open Diab Res Care. 2020;8:e000962. https://doi.org/10.1136/bmjdrc-2019-000962.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Shen SC, Lee WJ, Kasama K, Seki Y, Su YH, Wong SK, Huang YM, Wang W. Efficacy of Different Procedures of Metabolic Surgery for Type 2 Diabetes in Asia: a Multinational and Multicenter Exploratory Study. Obes Surg. 2021;31:2153–60. https://doi.org/10.1007/s11695-021-05239-7.

    Article  PubMed  Google Scholar 

  25. Park JY. Prediction of Type 2 Diabetes Remission after Bariatric or Metabolic Surgery. J Obes Metab Syndr. 2018;27:213–22. https://doi.org/10.7570/jomes.2018.27.4.213.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, Castagneto M, Bornstein S, Rubino F. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386:964–73. https://doi.org/10.1016/S0140-6736(15)00075-6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, Department of General Surgery, University of Firat, 23119, Elazig, Turkey

    Cuneyt Kirkil, Mesut Yur, Onur Ag & Muhammed Yusuf Bozcan

  2. Faculty of Health Sciences, Department of Nutrition and Dietetics, Ataturk University, 25240, Erzurum, Turkey

    Ilayda Aydin

Authors
  1. Cuneyt Kirkil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ilayda Aydin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mesut Yur
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Onur Ag
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Muhammed Yusuf Bozcan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cuneyt Kirkil.

Ethics declarations

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

All authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The study was accepted for oral presentation at the 8th International Morbid Obesity and Metabolic Disorders Congress, 5-8 October 2023, in Antalya, Turkey.

Key points

• ABCD score accurately predicts remission of T2DM after TB.

• Patients with a score of 2 to 3 are more likely to experience remission after TB.

• For individuals with T2DM, the ABCD score can be utilized to choose kind of surgery.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kirkil, C., Aydin, I., Yur, M. et al. Comparison of the ABCD Score's Accuracy in Predicting Remission of Type 2 Diabetes Mellitus One Year After Sleeve Gastrectomy, One Anastomosis Gastric Bypass, and Sleeve Gastrectomy with Transit Bipartition. OBES SURG 34, 133–140 (2024). https://doi.org/10.1007/s11695-023-06950-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-023-06950-3

Keywords

Search

Navigation