{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:29:42Z","timestamp":1789046982315,"version":"build-2803163510"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008994","name":"Universidade De Bras\u00edlia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008994","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alcohol use disorder (AUD) after bariatric surgery is increasingly recognized but remains under-detected because routine screening relies on self-report. We aimed to identify clinical and psychometric predictors of a positive alcohol screen and to build a simple risk-stratification model; as a secondary objective, we critically evaluated whether a routinely available hepatic enzyme, temporally anchored gamma-glutamyl transferase (GGT), adds information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single-center cross-sectional analysis of 130 adults who had undergone Roux-en-Y gastric bypass (RYGB) and completed the Cut-down\/Annoyed\/Guilty\/Eye-opener (CAGE) and AUDIT questionnaires during routine follow-up at a private clinic in Brazil. Questionnaire responses were linked to an institutional clinical-laboratory database. The primary outcome was a positive AUDIT screen (score\u2009\u2265\u20098). Multivariable logistic regression with 5,000 bootstrap resamples identified independent predictors. As a secondary, exploratory analysis, the GGT measurement closest to the questionnaire date was selected within \u00b1\u20096-, \u00b1\u200912-, and \u00b1\u200924-month windows and compared between groups, with Benjamini-Hochberg correction across a four-marker hepatic-enzyme set; a linear mixed model examined longitudinal GGT trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A positive AUDIT screen was identified in 32 patients (24.6%). Median age was 47 years (interquartile range [IQR] 37\u201358; mean 47.4\u2009\u00b1\u200912.6), and 80% were women. Male sex (OR 5.3, 95% CI 1.9\u201314.3) and paternal alcohol use (OR 5.5, 95% CI 2.2\u201313.7) were independent predictors; a two-variable model served as a candidate risk-stratification approach with selection-aware optimism-corrected internal performance (c-index 0.71; calibration slope 0.97), stratifying predicted risk from 9% (neither factor) to 75% (both, small stratum), and would require external validation before clinical use. In the AUDIT-anchored\u2009\u00b1\u20096-month subgroup (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200958), GGT was higher among screen-positive patients (median 31 vs. 15.5 U\/L; AUC 0.72) but did not survive false-discovery-rate (FDR) correction (q\u2009=\u20090.055), and both medians remained within the reference range. A secondary, exploratory database analysis (Supplement) was directionally consistent at the group level but rested on an imperfect, construct-distinct label and is not confirmatory. The mixed model did not detect a divergent longitudinal GGT trajectory (\u03b2\u2009=\u20090.02 log-units\/year, 95% CI\u2009\u2212\u20090.02 to 0.06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After bariatric surgery, male sex and paternal alcohol use are strong, easily ascertained predictors of a positive alcohol screen in this cohort and can be translated into a simple, bedside risk-stratification approach (a candidate requiring external validation). GGT shows a weak, group-level association with alcohol use \u2014 specific within the hepatic-enzyme panel tested, yet within the reference range and uninformative at the individual level \u2014 so it may complement, but cannot replace, psychometric screening. These findings favor psychometric screening focused on identifiable risk strata, with routine GGT as at most a supportive signal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08855-3","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:38:29Z","timestamp":1785393509000},"page":"4677-4686","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Psychometric Predictors of a Positive Alcohol Use Disorder Screen after Roux-en-Y Gastric Bypass: A Cross-Sectional Study"],"prefix":"10.1007","volume":"36","author":[{"given":"Sergio Lincoln de Matos","family":"Arruda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"de Negreiros Botan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Oliveira","family":"Galv\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Fiuza","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Silva Melendez","family":"Ara\u00fajo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Sampaio Carvalho","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Batista","family":"de Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"issue":"23","key":"8855_CR1","doi-asserted-by":"publisher","first-page":"2516","DOI":"10.1001\/jama.2012.6147","volume":"307","author":"WC King","year":"2012","unstructured":"King WC, Chen JY, Mitchell JE, et al. 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