Obesity Surgery

, Volume 24, Issue 10, pp 1709–1716

Baseline Abdominal Lipid Partitioning Is Associated with the Metabolic Response to Bariatric Surgery

Authors

  • Andrei Keidar
    • Bariatric Surgery Service, Department of SurgeryRabin Hospital
    • General Surgery DepartmentHadassah Ein Kerem Medical Center
  • Liat Appelbaum
    • Radiology DepartmentHadassah Ein Kerem Medical Center
  • Chaya Schweiger
    • Bariatric Surgery Service, Department of SurgeryRabin Hospital
  • Karen Hershkop
    • Department of Human Metabolism and NutritionHebrew University School of Medicine
  • Idit Matot
    • Department of Anesthesiology and Critical Care MedicineSourasky Medical Center affiliated with the Tel Aviv University
  • Naama Constantini
    • Department of Orthopedic SurgeryThe Hadassah-Hebrew University Medical Center
  • Jacob Sosna
    • Radiology DepartmentHadassah Ein Kerem Medical Center
    • Department of Human Metabolism and NutritionHebrew University School of Medicine
Original Contributions

DOI: 10.1007/s11695-014-1249-3

Cite this article as:
Keidar, A., Appelbaum, L., Schweiger, C. et al. OBES SURG (2014) 24: 1709. doi:10.1007/s11695-014-1249-3

Abstract

Background

The purpose of this study was to compare the effects of two bariatric procedures on abdominal lipid partitioning and metabolic response.

Methods

Fifty-one patients (RYGB 31(11 M/20 F); (SG) 20(8 M/12 F)) who met the criteria of metabolic syndrome before the operation were followed following Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Visceral and subcutaneous abdominal fat depots were assessed by CT before, 6 months, and 12 months following the operation.

Results

Patients undergoing both procedures did not differ in baseline body mass index (BMI) (42.84 ± 4.65 vs. 41.70 ± 4.68 kg/m2) or abdominal lipid depots. BMI at 12 months post-op was similar (29.44 ± 3.35 vs 30.86 ± 4.31 kg/m2 for RYGB and SG, respectively). Both procedures led to a significant reduction in visceral and subcutaneous fat at 6 months (p < 0.001 for both). The visceral-to-subcutaneous fat ratio was comparable at 6 months vs. baseline yet was lower at 12 months vs. baseline for both procedures (p < 0.01). In patients who lost the diagnosis of metabolic syndrome, baseline visceral/subcutaneous fat was the only predictor of recovery (p < 0.005). No difference was detected between procedures in dynamics of abdominal fat depots or remission of cardiovascular risk factors.

Conclusions

RYGB and SG induce a similar effect on abdominal fat mobilization. The metabolic effects in individual patients are mostly determined by their baseline abdominal lipid partitioning.

Keywords

Bariatric surgeryVisceral fatSubcutaneous fatMetabolic syndrome

Copyright information

© Springer Science+Business Media New York 2014