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Cardiometabolic Profile Related to Body Adiposity Identifies Patients Eligible for Bariatric Surgery More Accurately than BMI

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Abstract

Background

Eligibility criteria for bariatric surgery (BS) are based on BMI and the presence of major comorbidities. Our aim was to analyze the usefulness of body adiposity determination in establishing the indication for BS.

Methods

In order to analyze the cardiometabolic risk according to eligibility criteria for BS, four groups were studied. Morbidly obese patients with BMI ≥40 kg/m2 (n = 360), and obese subjects with BMI ≥35 kg/m2 and at least one comorbidity (n = 431), represented two groups of patients meeting original NIH criteria for BS. A third group included two cohorts of patients with a high body fat (BF)% that do not meet the original NIH eligibility criteria for BS: patients with either a BMI <35 kg/m2 or a BMI ≥35 kg/m2 without comorbidities (n = 266, NEHF). Lean subjects by BMI were the reference group (n = 140). BMI, BF% and markers of insulin sensitivity, lipid profile, and cardiovascular risk were measured.

Results

Individuals from the NEHF group exhibited increased HbA1c (P < 0.05) and decreased insulin sensitivity evidenced by a significant reduction in QUICKI (P < 0.001). Triglyceride concentrations were similarly increased (P < 0.05) in the three groups of obese patients. Uric acid concentrations were significantly elevated (P < 0.01) to a similar extent in the obese groups. Levels of the inflammatory marker CRP and hepatic enzymes were significantly increased in the three obese groups.

Conclusion

The present study provides evidence for the existence of an adverse cardiometabolic profile in subjects currently considered to be outside traditional NIH guidelines but exhibiting a highly increased adiposity. It is concluded that body composition analysis yields valuable information to be incorporated into indication criteria for BS and that adiposity may be an independent indicator for BS.

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Acknowledgments

The authors thank all of the members of the Nutrition Unit of the Department of Endocrinology & Nutrition (Clínica Universidad de Navarra, Pamplona, Spain) for their technical help.

Funding

The study was supported by grants from the ISCIII (PI09/91029, PI11/02681 and PI12/00515), the Department of Health (31/2009) of the Gobierno de Navarra, Fundación Caja Navarra (20–2014) and by the ISCIII, Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, CIBERobn, Spain.

Conflict of Interest

All authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008, Pamplona, Spain

    Javier Gómez-Ambrosi, Beatriz Ramírez, Victoria Catalán, Amaia Rodríguez & Gema Frühbeck

  2. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), ISCIII, 31008, Pamplona, Spain

    Javier Gómez-Ambrosi, Víctor Valentí, Camilo Silva, Beatriz Ramírez, Victoria Catalán, Amaia Rodríguez, Javier Escalada, Javier A. Cienfuegos, María J. Gil, Javier Salvador & Gema Frühbeck

  3. Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain

    Javier Gómez-Ambrosi, Rafael Moncada, Víctor Valentí, Camilo Silva, Beatriz Ramírez, Victoria Catalán, Amaia Rodríguez, María J. Gil & Gema Frühbeck

  4. Department of Anaesthesiology, Clínica Universidad de Navarra, 31008, Pamplona, Spain

    Rafael Moncada

  5. Department of Surgery, Clínica Universidad de Navarra, 31008, Pamplona, Spain

    Víctor Valentí, Carlos Pastor & Javier A. Cienfuegos

  6. Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Avda. Pío XII 36, 31008, Pamplona, Spain

    Camilo Silva, Patricia Andrada, Javier Escalada, Javier Salvador & Gema Frühbeck

  7. Department of Biochemistry, Clínica Universidad de Navarra, 31008, Pamplona, Spain

    María J. Gil

Authors
  1. Javier Gómez-Ambrosi
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  2. Rafael Moncada
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  5. Beatriz Ramírez
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  6. Victoria Catalán
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  7. Amaia Rodríguez
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  8. Patricia Andrada
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  9. Javier Escalada
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  10. Carlos Pastor
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  11. Javier A. Cienfuegos
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  12. María J. Gil
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  13. Javier Salvador
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  14. Gema Frühbeck
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Corresponding author

Correspondence to Gema Frühbeck.

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Gómez-Ambrosi, J., Moncada, R., Valentí, V. et al. Cardiometabolic Profile Related to Body Adiposity Identifies Patients Eligible for Bariatric Surgery More Accurately than BMI. OBES SURG 25, 1594–1603 (2015). https://doi.org/10.1007/s11695-014-1566-6

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  • DOI: https://doi.org/10.1007/s11695-014-1566-6

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