Abstract P144: Bariatric Surgery Normalizes Diabetes Risk Index By 1 Month Post-operation

Abstract

The Diabetes Risk Index (DRI) is a composite of NMR-measured lipoproteins and branched chain amino acids shown to be predictive of diabetes in prospective cohorts. Bariatric surgery is indicated in patients with severe obesity, many of whom are at high-risk for developing diabetes. Substantial weight loss occurs after bariatric surgery and sustained weight loss likely contributes to lower risk of diabetes and cardiovascular disease. However, evidence suggests that bariatric surgical procedures themselves may contribute to reducing risk independent of weight loss. We aimed to investigate DRI and its association with weight loss over one year following bariatric surgery. We examined 51 severely obese premenopausal women without diabetes, 25 of whom met criteria for metabolic syndrome. DRI, BMI, body weight and waist measurements were made before and at 1, 6 and 12 months after Roux-en-Y Gastric Bypass or Sleeve Gastrectomy. Values were compared to healthy women with normal BMI (18.5 - 24.9 kg/m 2 ; n=15). Obese (BMI 44.7 ± 6.2 kg/m 2 ) subjects had significantly elevated DRI scores prior to surgery (35 [26, 39] vs 12 [1, 20]; p <0.0001). At 1 month after surgery, BMI had decreased 5.1 ± 1.1 kg/m 2 , but DRI decreased so that it no longer differed from that of normal BMI controls (Figure). Subjects continued to lose weight, whereas DRI remained similar, throughout 12 months. Changes in DRI did not correlate with changes in BMI, body weight or waist circumference at any time during follow-up (r = -0.16 - 0.16). There was no difference in response between surgeries or pre-operative metabolic syndrome status. Our analysis of DRI scores supports the capacity of bariatric surgery to reduce risk of developing diabetes in severely obese individuals with or without metabolic syndrome. The rapidity of normalization and the lack of associations with weight loss or anthropometric changes suggest that bariatric surgical techniques may have inherent effects that improve cardiometabolic risk.