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Effect of Laparoscopic Roux-en-Y gastric Bypass on Body Composition and Insulin Resistance in Chinese Patients with Type 2 Diabetes Mellitus

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Abstract

Background

This study aims to assess the effect of laparoscopic Roux-en-Y gastric bypass (LRYGB) on body composition, fat distribution, and insulin resistance (IR) in Chinese type 2 diabetes mellitus (T2DM) patients.

Methods

Eighteen patients with T2DM were studied before and 3 months post LRYGB. Fasting plasma glucose (FPG), fasting insulin (FINS), and triglyceride (TG) were measured. IR index was determined using the homeostasis model assessment of insulin resistance (HOMA-IR). Body composition and fat distribution were measured by dual-energy X-ray absorptiometry (DXA). Fat mass (FM), muscle mass (MM), bone mineral content (BMC), and percent fat mass (%FM) at the whole body and five body regions including the arms, legs, trunk, android, and gynoid were obtained from DXA scans.

Results

HOMA-IR decreased from 5.02 at baseline to 1.43 3 months post LRYGB (p < 0.05). There was significant decrease in total and regional body mass and body fat (all p < 0.05). A significant reduction was observed in %FM at every tested body region (all p < 0.05). There was more fat mass loss (31.03 %) in android region than any other tested body region. Preoperative android %FM was significantly correlated with IR (r = 0.49, p < 0.05). Changes in android FM showed significant correlations with changes in IR, FPG, FINS, and TG (r = 0.54, 0.64, 0.54, and 0.67, respectively; all p < 0.05).

Conclusions

Body composition in Chinese T2DM patients is rebalanced after LRYGB. Reduction of central obesity can result in improvement of IR, and android fat distribution may be a good indicator of postoperative benefits for LRYGB.

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Abbreviations

IDF:

International diabetes federation

ADA:

American Diabetes Association

LRYGB:

Laparoscopic Roux-en-Y gastric bypass

T2DM:

Type 2 diabetes mellitus

IR:

Insulin resistance

HOMA-IR:

Homeostasis model assessment of insulin resistance

LNIR:

Natural logarithm of HOMA-IR

BMI:

Body mass index

WC:

Circumference of the waist

WHR:

Waist to hip ratio

OGTT:

Oral glucose tolerance test

FPG:

Fasting plasma glucose

FINS:

Fasting insulin

TG:

Triglyceride

DXA:

Dual-energy X-ray absorptiometry

FM:

Fat mass

MM:

Muscle mass

BMC:

Bone mineral content

BW:

Body weight

%FM:

Percent fat mass

A/G:

Android to gynoid ratio in %FM

%Change:

Percentage of change

SAT:

Subcutaneous adipose tissue

VAT:

Visceral adipose tissue

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Conflict of Interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, People’s Republic of China

    Weizheng Li, Liyong Zhu, Xiangwu Yang, Guohui Wang, Pengzhou Li, Juan Tan, Fei Ye & Shaihong Zhu

  2. Department of Endocrinology, Third Xiangya Hospital, Central South University, Changsha, 410013, China

    Zhaohui Mo

  3. Department of Surgery, Englewood Hospital and Medical Center, 375 Engle Street, Englewood, NJ, 07631, USA

    Jeff Strain & Ibrahim Im

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  1. Weizheng Li
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Correspondence to Shaihong Zhu.

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Li, W., Zhu, L., Mo, Z. et al. Effect of Laparoscopic Roux-en-Y gastric Bypass on Body Composition and Insulin Resistance in Chinese Patients with Type 2 Diabetes Mellitus. OBES SURG 24, 578–583 (2014). https://doi.org/10.1007/s11695-013-1116-7

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  • DOI: https://doi.org/10.1007/s11695-013-1116-7

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