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The Relationship Between BMI, Body Composition, and Fat Mass Distribution in Rou-en-Y Gastric Bypass Patients

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Abstract

Background

Type 2 diabetes mellitus (T2DM) with central obesity is a common clinical presentation in Chinese patients. Body mass index (BMI) is a criterion determining central obesity that, when combined with dual-energy X-ray absorptiometry (DXA), accurately reflects body composition and fat mass distribution. The utility of DXA-derived measures in the evaluation of metabolic surgery still needs to be investigated.

Methods

In this cohort study, 78 Chinese patients with central obesity (WC ≥ 90 cm for males, WC ≥ 85 cm for females) or BMI above 27.5 kg/m2 underwent gastric bypass between October 2010 and October 2012. The patients were followed for 12 months. Preoperative, perioperative, and postoperative metabolic parameters and DXA results were prospectively collected and analyzed.

Results

A total of 57 of 78 cases (73.1%) were diagnosed with central obesity. There was a significant decrease in BMI, WC, and WHR at each point in time (P < 0.05), with fasting plasma glucose (FPG), fasting insulin secretion (FINS), and the homeostasis model assessment of insulin resistance index (HOMA-IR) also significantly improved. Body fat mass percentage (%BF) results showed significant decreases in different regions. %BF regions, except for trunk region %BF, were significantly correlated with BMI and WC (P < 0.01). Pearson correlation coefficients of 0.562 and 0.577 were evident between BMI and total %BF, and android %BF and WC, respectively. Linear regression analysis was conducted to assess the linear relationship between BMI and %BF, and android %BF, WC, and WHR; linear formulas were derived.

Conclusions

%BF is a more significant predictor of obesity, with BMI significantly underestimating visceral adipose tissue (VAT). In addition to BMI, total %BF and android %BF have clinical utility as indicators for metabolic surgery evaluation as well as patient selection.

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Abbreviations

T2DM:

Type 2 diabetes mellitus

DXA:

Dual-energy X-ray absorptiometry

WC:

Waist circumference

BMI:

Body mass index

WHR:

Waist-hip ratio

FPG:

Fasting plasma glucose

FINS:

Fasting insulin

HOMA-IR:

Homeostasis model assessment of insulin resistance index

%BF:

Body fat mass percentage

VAT:

Visceral adipose tissue

MS:

Metabolic surgery

LRYGB:

Laparoscopic Rou-en-Y gastric bypass

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Funding

The paper was supported by the National Natural Science Foundation of China (81600431) and the Natural Science Foundation of Hunan Province of China (2017JJ3471).

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Authors and Affiliations

  1. Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, China

    Pengzhou Li, Guangnian Ji, Weizheng Li, Lei Zhao, Liyong Zhu & Shaihong Zhu

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  1. Pengzhou Li
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  2. Guangnian Ji
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  3. Weizheng Li
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  4. Lei Zhao
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  5. Liyong Zhu
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  6. Shaihong Zhu
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Correspondence to Liyong Zhu.

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Consent was obtained from all participants before the start of the study, which was conducted in compliance with the protocol approved by the Ethics Committee of our hospital.

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The authors declare that they have no conflict of interest.

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Li, P., Ji, G., Li, W. et al. The Relationship Between BMI, Body Composition, and Fat Mass Distribution in Rou-en-Y Gastric Bypass Patients. OBES SURG 30, 1385–1391 (2020). https://doi.org/10.1007/s11695-019-04300-w

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