Background
Visceral fat is determinant for obesity metabolic disturbances. Gold standard methods for its assessment are unfeasible in clinical practice. Adiposity indices have been proposed to provide a more feasible evaluation. The study aims to assess body fat distribution through adiposity indices, before and 6 months after Roux-en-Y gastric bypass(RYGB), and their correlation with body and biochemical variables.
Methods
prospective longitudinal study with adults undergoing RYGB, evaluated before(T0) and 6 months after surgery(T1). Weight, height, waist circumference(WC), BMI, waist-to-height ratio(WHtR), total cholesterol(TC), HDL-c, LDL-c, triglycerides(TG), insulin, glucose, HbA1c and HOMA-IR were evaluated. Visceral adiposity index(VAI), conicity index(CI), lipid accumulation product(LAP), Clinica Universidad de Navarra-Body adiposity estimator(CUN-BAE) and a body shape index(ABSI) were calculated.
Results
62 individuals, 80% women, mean age 42.8 ± 11.13 years. There was significant improvement in adiposity and all biochemical variables, even with more than 90% still in overweight/obesity class and/or inadequate WC and WHtR. Only 40% of individuals had VAI inadequacy at T1. Individuals with elevated VAI had higher HOMA-IR, TG and LAP at T0, compared to those with adequate VAI. Although this difference was not maintained at T1, after surgery, VAI was the only index that correlated with HOMA-IR. Pre-surgical ABSI, CI, WC and WHtR correlated with post-surgical HOMA-IR, insulin and TC. Only the post-surgical variation in ABSI correlated with HOMA-IR reduction.BMI did not correlate with post-surgical metabolic outcome.
Conclusion
The findings reinforce the ability of RYGB to reduce visceral adiposity, and the applicability of the indices to assess metabolic health, with emphasis on VAI and ABSI.
