Format

Send to

Choose Destination
Obes Surg. 2018 Dec;28(12):4006-4013. doi: 10.1007/s11695-018-3455-x.

The Reduction of Visceral Adipose Tissue after Roux-en-Y Gastric Bypass Is more Pronounced in Patients with Impaired Glucose Metabolism.

Author information

1
Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Rue Saint-Martin 3, 1003, Lausanne, Switzerland. lucie.favre@chuv.ch.
2
Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Rue Saint-Martin 3, 1003, Lausanne, Switzerland.
3
Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland.
4
Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland.
5
Department of Surgery, Riviera-Chablais Hospital, Aigle-Monthey, Switzerland.

Abstract

PURPOSE:

Visceral adipose tissue (VAT) is associated with cardiometabolic risk factors and insulin resistance. The physiological mechanisms underlying the benefits of Roux-en-Y gastric bypass surgery (RYGB) on glucose metabolism remain incompletely understood. The impact of RYGB on VAT was assessed among three groups of patients stratified by their glucose tolerance before surgery.

METHODS:

Forty-four obese women were categorized into normoglycemia (n = 21), impaired glucose tolerance (IGT, n = 18) and diabetes (n = 5) before surgery. Body composition measured by dual-energy X-ray absorptiometry (DXA) was performed before surgery, 6 months and 12 months after.

RESULTS:

The three groups had comparable mean age (mean 38.6 ± SD 9.9) and BMI at baseline (41.9 ± 4.3 kg/m2). After 12 months, total weight loss (mean 35.1% ± 7.5) and excess weight loss (91.1% ± 25.1) were similar between groups. Pre-surgery mean VAT was significantly higher in diabetes (mean 2495 ± 616 g) than in normoglycemia (1750 ± 617 g, p = 0.02). The percentage of VAT to total body fat was significantly higher in diabetes (mean 4.4% ± 0.9) compared to normoglycemia (2.9% ± 0.8, p = 0.003). Twelve months after surgery, VAT loss was significantly greater among patients with diabetes (mean 1927 ± 413 g) compared to normoglycemia (1202 ± 450, p = 0.009).

CONCLUSIONS:

RYGB leads to important VAT loss, and this loss is greater in patients with diabetes prior to surgery. As VAT is associated with insulin resistance, this reduction may account for the profound impact of this surgery on glucose metabolism.

KEYWORDS:

Bariatric surgery; Dual-energy X-ray absorptiometry (DXA); Roux-en-Y gastric bypass; Type 2 diabetes; Visceral adipose tissue

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center