Bariatric surgery in obesity: Changes of glucose and lipid metabolism correlate with changes of fat mass

F. Frige', M. Laneri, A. Veronelli, F. Folli, M. Paganelli, P. Vedani, M. Marchi, D. Noe', P. Ventura, E. Opocher, A. E. Pontiroli

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Background and Aim: Bariatric surgery induces significant weight loss and improves glucose metabolism in obese patients (BMI > 35 kg/m2). Our aim was to compare restrictive (LAGB, laparoscopic gastric banding) and malabsorptive approaches (BIBP, biliary-intestinal bypass) on the loss of fat-free mass (FFM), fat mass (FM), and on changes of glucose and lipid metabolism. Methods and Results: Body composition (bio-impedance analysis, BIA), blood glucose (BG), insulin, triglycerides, total- and HDL-cholesterol, liver enzymes (AST and ALT) were measured at baseline and 1 year after surgery in patients undergoing LAGB, BIBP, and in diet-treated control patients. In the main study, with patients matched for initial BMI (43-55 kg/m2, LAGB = 24, BIBP = 12, controls = 6), decreases of BMI, FM, BG and cholesterol were greater in patients with BIBP than with LAGB (p < 0.01), while decreases of FFM, insulin, HOMA-IR and triglycerides were similar. No effects on BMI, FM, FFM, BG, insulin, HOMA-IR or cholesterol were observed in the control patients. Decreases of BG, insulin, HOMA-IR, cholesterol and triglycerides correlated with FM but not with FFM decrease. Similar results were obtained in an additional study in patients with a different initial BMI (LAGB = 25, BIBP = 6, controls = 24) and when considering all subjects together. A decrease of liver enzymes (ALT) was greater with LAGB than with BIBP, and HDL-cholesterol increased with LAGB and decreased with BIBP. Conclusion: BMI, FM, BG and cholesterol decrease more with malabsorptive than with restrictive surgery, while FFM, insulin, HOMA-IR and triglycerides decrease in a similar way. FFM loss is of low entity. Changes of glucose and lipid metabolism are proportional to a decrease of fat mass but not of fat-free mass.

Original languageEnglish (US)
Pages (from-to)198-204
Number of pages7
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume19
Issue number3
DOIs
StatePublished - Mar 1 2009

Keywords

  • Bariatric surgery
  • Body composition
  • Glucose metabolism
  • Lipid metabolism
  • Obesity

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

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    Frige', F., Laneri, M., Veronelli, A., Folli, F., Paganelli, M., Vedani, P., Marchi, M., Noe', D., Ventura, P., Opocher, E., & Pontiroli, A. E. (2009). Bariatric surgery in obesity: Changes of glucose and lipid metabolism correlate with changes of fat mass. Nutrition, Metabolism and Cardiovascular Diseases, 19(3), 198-204. https://doi.org/10.1016/j.numecd.2008.04.005