Body fat mass and distribution as predictors of metabolic outcome and weight loss after Roux-en-Y gastric bypass

Hogling, Daniel Eriksson; Rydén, Mikael; Bäckdahl, Jesper; Thorell, Anders; Andersson, Daniel P.

doi:10.1016/j.soard.2018.03.012

Cited by 14 publications

(6 citation statements)

References 144 publications

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“…We failed to find correlations between preoperative BMI/ weight and weight loss after surgery, in line with some studies [16][17][18][19], but contrarily to others reporting a negative association between baseline BMI, waist circumference, waist-to-height ratio and post-BS weight loss at different follow-up times [3,6,9,11,15,17,20,29]. Indeed, weight and BMI are both inaccurate measures of body composition with respect to fat distribution [48].…”

Section: Discussionsupporting

confidence: 78%

What predicts the unsuccess of bariatric surgery? An observational retrospective study

D’Eusebio

Boschetti

Rahimi

et al. 2020

J Endocrinol Invest

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Purpose Bariatric surgery (BS) has been recognized as an effective treatment for most patients with morbid obesity, but a variable range of patients failed to achieve a successful weight-loss. Controversial data are available about predictors of unsuccess. We aimed to retrospectively assess whether clinical baseline characteristics of patients submitted to sleeve gastrectomy (SL) or gastric bypass (GBP) were associated with unsuccessful weight-loss after 12 and 24-month follow-up. Methods Three hundred patients who underwent BS from the 1st January 2016, with at least 24-months follow-up, were enrolled. Patients were divided according to their percentage of excess weight-loss (%EWL) either < 50% or ≥ 50% after 12 and 24-month follow-up. Results None of the patients was lost at follow-up; 56 (18.7%) patients showed a %EWL < 50% at 24 months. Age, neck circumference, obstructive sleep apnea (OSA) were significantly higher, while total cholesterol and %EWL 6-months lower in those with %EWL < 50% at 12-months. Age, neck circumference, male and OSA rates were increased, while %EWL at 6-months lower in patients with %EWL < 50% at 24-months. In a multiple regression model, age (OR = 1.076; 95% CI 1.

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Section: Discussionsupporting

confidence: 78%

What predicts the unsuccess of bariatric surgery? An observational retrospective study

D’Eusebio

Boschetti

Rahimi

et al. 2020

J Endocrinol Invest

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“…In the previous studies a higher relative reduction of visceral fat as compared to other compartments was observed [ 23 – 26 ]. The authors of Swedish study examined body composition of 166 women before and 2 years after RYGB.…”

Section: Discussionmentioning

confidence: 91%

“…The authors of Swedish study examined body composition of 166 women before and 2 years after RYGB. They found that visceral fat to total fat mass ratio, as well as android to gynoid fat mass ratio decreased, suggesting that visceral adipose tissue within the android region, determined by DXA software in the upper part of the abdomen, is more mobilized than subcutaneous fat depots [ 23 ]. Maïmoun et al showed that within 12 months following LSG, abdominal visceral fat, measured with DXA in 30 obese patients, decreased by 44.6%, while abdominal subcutaneous adipose tissue decreased by 39.7% [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Influence of Laparoscopic Sleeve Gastrectomy on Body Composition and Fat Distribution in Obese Caucasian Men and Women

et al. 2020

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Background The aim of the study was to assess changes in body composition in patients subjected to laparoscopic sleeve gastrectomy (LSG). Methods Changes in body composition following LSG were determined in a group of 155 patients with obesity (117 women and 38 men), with dual-energy X-ray absorptiometry (DXA). Whole body fat mass (FM) and lean body mass (LBM) were determined, and abdominal fat mass (AbdF) was assessed within the region extending from the top of the pubic bone up to the line between 12th thoracic and 1st lumbar vertebras. Results Over the period of 12 months following LSG, body mass index decreased by 28.2 ± 9.0% (p < 0.001). The reduction of body weight by 35.4 ± 12.6 kg (p < 0.001) was the result of a decrease in FM by 23.9 ± 8.9 kg (p < 0.001) and LBM by 10.5 ± 3.8 kg (p < 0.001). AbdF decreased from 13.2 ± 3.1 to 8.2 ± 2.7 kg (p < 0.001), but abdominal fat to total fat mass ratio increased from 24.9 ± 4.7 to 28.0 ± 5.8% (p < 0.001). The loss of AbdF was more pronounced in men than in women. The rate of FM loss was attenuated with patients' age. Conclusions Over the period of 12 months following LSG, the reduction of FM was more than twice as much as decrease of LBM. The loss of AbdF was slower than a loss of peripheral subcutaneous fat.

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“…The cohort studied herein was combined from two clinical trials (NCT01785134 and NCT01727245 at clinicaltrials.gov ) with a similar study design, and main outcomes have been reported [ 18 , 19 ]. Baseline characteristics of the entire cohort before and after weight loss have been presented previously [ 20 ]. Subjects with insulin, glitazone, or glucocorticoid treatment were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…A total of 215 women were included at baseline before surgery, and 166 (77.2%) were followed up 2 years after RYGB. Clinical characteristics of the cohort (n = 166) at baseline and after weight loss have been reported previously [20]. Mean BMI at baseline was 40.5 ± 4.2 kg/m 2 and age 42.6 ± 9.5 years.…”

Section: Clinical Characteristicsmentioning

confidence: 95%

Metabolic Impact of Body Fat Percentage Independent of Body Mass Index in Women with Obesity Remission After Gastric Bypass

et al. 2019

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Background/Objective Body mass index (BMI) is central when evaluating treatment effect after gastric bypass. The metabolic impact of BMI-independent differences in body fat percentage (BF%) after gastric bypass is not fully understood. We compared metabolic and adipose tissue characteristics in women with high versus low BF% independent of BMI after obesity remission following gastric bypass. Subjects/Methods A cohort of 215 women was included at baseline. A total of 166 women were re-examined 2 years after gastric bypass, whereof 130 had obesity remission (BMI < 30 kg/m 2 ). Anthropometric parameters, blood pressure, and lipids were measured. Total and regional body fat mass was determined by dual-energy X-ray absorptiometry. Insulin sensitivity was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and hyperinsulinemic euglycemic clamp ( M value). Adipocyte size and number were determined. Results Of the 130 women with obesity remission, 64 had BF% ≥ 35 and 65 < 35. Independent of BMI, high BF% were associated with higher HOMA-IR ( P = 0.021), lower M value ( P = 0.0046), higher triglycerides ( P = 0.013), higher visceral/total and android/gynoid fat mass ratios ( P = 0.0032 and 0.0003 respectively), and larger subcutaneous fat cell volume ( P < 0.0001) 2 years after gastric bypass. No differences in anthropometric measures, glucose, blood pressure, or fat cell number were observed. Conclusions Independent of BMI, patients with higher BF% displayed lower insulin sensitivity, higher triglyceride levels, central fat distribution, and larger subcutaneous adipocytes 2 years after gastric bypass. Thus, determination of BF% provides additional information of metabolic characteristics at follow-up of non-obese patients after gastric bypass.

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Body fat mass and distribution as predictors of metabolic outcome and weight loss after Roux-en-Y gastric bypass

Cited by 14 publications

References 144 publications

What predicts the unsuccess of bariatric surgery? An observational retrospective study

What predicts the unsuccess of bariatric surgery? An observational retrospective study

The Influence of Laparoscopic Sleeve Gastrectomy on Body Composition and Fat Distribution in Obese Caucasian Men and Women

Metabolic Impact of Body Fat Percentage Independent of Body Mass Index in Women with Obesity Remission After Gastric Bypass

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