Optimization of change in epicardial fat thickness for obese patients who lost weight via the bariatric surgery method using central composite and Box-Behnken experimental designs

• Published in: PeerJ (San Francisco, CA) Vol. 9; p. e11831
• Main Authors: Elmalı, Ferhan, Tekindal, Mustafa Agâh, Altın, Cihan, Ateş, Can, Erol, Varlık
• Format: Journal Article
• Language: English
• Published: United States PeerJ. Ltd 04-08-2021; PeerJ, Inc; PeerJ Inc
• Subjects: Age; Bariatric surgery; Body fat; Body mass index; Box-Behnken design; Cardiology; Cardiovascular disease; Central composite design; Factorial experiments; Gastrointestinal surgery; Medical research; Medicine, Experimental; Metabolic Sciences; Metabolic syndrome; Methods; Obesity; Patients; Radiology and Medical Imaging; Response surface method; Statistics; Surgery; Surgery and Surgical Specialties; Values; Central composite design; Box-Behnken design; Response surface method; Bariatric surgery
• ISSN: 2167-8359; 2167-8359
• DOI: 10.7717/peerj.11831

The aim of this study was to detect the optimal values for Age, Body Mass Index (BMI) and HOMA-IR of obese patients prior to surgery that results in a maximal decrease of visceral fat mass 6 months after bariatric surgery.
In this study, 3
experimental set-ups were designed. This study was approved by Baskent University Medical and Health Sciences Research Board (Approval number: KA16/281). The study data consisted of 40 obese patients who lost weight through the bariatric surgery between February 2015 and December 2016. The values of BMI, Age and HOMA for the obese patients who lost weight through the bariatric surgery were evaluated in three categories and at three levels; the response variable was determined as the Change in Epicardial Fat Thickness (ΔEFT).
As a result of CCD analysis, the optimum ΔEFT = 2.571 was determined when Age = 30.52, BMI = 45.30, and HOMA = 34.62. As a result of the BBD analysis, the optimum ΔEFT = 3.756 was determined, when Age = 38.36, BMI = 63.18, and HOMA = 14.95. The optimum ΔEFT was modeled with Contour and Response Surface plots.
Based on the two surface response models used in our study, the maximal decrease of visceral fat mass as assessed by measuring echography images of epicardial fat thickness can be obtained by bariatric surgery of persons who are between 31 and 38 year old, have a BMI between 45 and 63 kg/m2 and have a HOMA-IR 34 between 15 and 35. Central Composite Design and a Box-Behnken Design of suitable patient data predicted 35 optimal settings of independent variables for the maximal clinical response of an intervention.