The Longitudinal Assessment of Bariatric Surgery (LABS) was conceived to address important issues in bariatric surgery and in disease pathogenesis and pathophysiology in the obese and morbidly obese. LABS explores relationships among patient characteristics, clinical conditions and co-morbidities, serologic and genetic markers, surgical procedures and other aspects of care, with clinical, psychosocial and health economic outcomes. LABS'primary achievements in its first 5 years have been to define the domains of exploration, identify appropriate metrics, and design and implement two major and several more restricted protocols. By 12/31/2007 LABS had completed enrollment and initial surgery in a cohort of 4,772 obese patients (median BMI 46.5) to study short-term safety of bariatric surgery (LABS-1), and as of October 13, 2008 had enrolled and completed surgery in 1,991 of the planned 2,400 person cohort in whom longer-term safety and efficacy will be studied (LABS-2). These studies employ the rigorous research infrastructure the LABS has built at 6 Clinical Centers representing diverse care delivery systems and patient populations. LABS patients are enrolled at 6 academic &4 affiliated community hospitals, undergoing operations by 33 surgeons. The result is a unique LABS-2 cohort with heterogeneous patient characteristics undergoing a diversity of surgical procedures. LABS is now seeking funding for a 5 year extension to enable it to address scientifically important research questions from the LABS-2 study that cannot be addressed with the limited follow-up currently supported. This extension would permit LABS to evaluate the durability of weight loss and comorbidity improvement, as well increasingly recognized late-emerging effects of surgery such as hypoglycemia and suicide, and effects that change over time. The critical scientific advantages of the multi- center LABS consortium include heterogeneity of the participant base, the ability to recruit a large number of patients in important sub-groups, and an existing research infrastructure with rigorous data collection practices, high levels of data accuracy and completeness, rigorous follow-up, and a comprehensive database of cleariy defined data elements to address these important issues.

Public Health Relevance

The obesity epidemic has profound health issues, e.g. -300,000 deaths/year, a reduction in life expectancy, and enormous costs. Bariatric surgery seems the most reliable means to major weight loss and correction of co-morbidities (e.g. type 2 diabetes). While its safety &long-term benefit remain uncertain, ~250,000 annual operations are expected. This proposal seeks to extend LABS studies that will answer many of these issues.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
3U01DK066667-11S1
Application #
8727908
Study Section
Special Emphasis Panel (ZDK1-GRB-6 (M1))
Program Officer
Horlick, Mary
Project Start
2003-09-30
Project End
2014-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
11
Fiscal Year
2013
Total Cost
$165,000
Indirect Cost
Name
Columbia University (N.Y.)
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Field, Alison E; Inge, Thomas H; Belle, Steven H et al. (2018) Association of Obesity Subtypes in the Longitudinal Assessment of Bariatric Surgery Study and 3-Year Postoperative Weight Change. Obesity (Silver Spring) 26:1931-1937
O'Rourke, Robert W; Johnson, Geoffrey S; Purnell, Jonathan Q et al. (2018) Serum biomarkers of inflammation and adiposity in the LABS cohort: associations with metabolic disease and surgical outcomes. Int J Obes (Lond) :
Purnell, Jonathan Q; Johnson, Geoffrey S; Wahed, Abdus S et al. (2018) Prospective evaluation of insulin and incretin dynamics in obese adults with and without diabetes for 2 years after Roux-en-Y gastric bypass. Diabetologia 61:1142-1154
King, Wendy C; Hinerman, Amanda S; Belle, Steven H et al. (2018) Comparison of the Performance of Common Measures of Weight Regain After Bariatric Surgery for Association With Clinical Outcomes. JAMA 320:1560-1569
Friedman, Allon N; Wahed, Abdus S; Wang, Junyao et al. (2018) Effect of Bariatric Surgery on CKD Risk. J Am Soc Nephrol 29:1289-1300
King, Wendy C; Chen, Jia-Yuh; Courcoulas, Anita P et al. (2017) Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Relat Dis 13:1392-1402
King, Wendy C; Chen, Jia-Yuh; Belle, Steven H et al. (2017) Use of prescribed opioids before and after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Relat Dis 13:1337-1346
Menke, Marie N; King, Wendy C; White, Gretchen E et al. (2017) Contraception and Conception After Bariatric Surgery. Obstet Gynecol 130:979-987
Kalarchian, Melissa A; King, Wendy C; Devlin, Michael J et al. (2016) Psychiatric Disorders and Weight Change in a Prospective Study of Bariatric Surgery Patients: A 3-Year Follow-Up. Psychosom Med 78:373-81
Alfonso-Cristancho, Rafael; King, Wendy C; Mitchell, James E et al. (2016) Longitudinal Evaluation of Work Status and Productivity After Bariatric Surgery. JAMA 316:1595-1597

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