Abstract
We investigated the association between body composition and changes in glucose metabolism following laparoscopic sleeve gastrectomy (LSG) in obese Japanese patients. Thirty-two Class III obese patients were assessed before LSG and 3, 6, and 12 months postoperatively. Variables including fat mass (FM), % body fat (%FM), total and skeletal muscle mass (MM), the ratio of lower extremity MM to body weight (BW) (L/W), and the ratio of upper extremity MM to BW (U/W) were measured while using bioelectrical impedance analysis (BIA). LSG significantly decreased BW, FM, and %FM in all time periods observed after surgery with concomitant improvements in metabolic markers. MM was decreased at three months but maintained from 3–12 months post-surgery. Importantly, %MM, U/W, and the L/W ratio increased after LSG. Furthermore, change in FM was positively correlated with change in BW 12 months after LSG, whereas changes in %MM were negatively correlated with fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). Finally, multivariable stepwise regression analyses showed that changes in % total MM was an independent determinant of FPG and change in % skeletal MM was a significant independent determinant of HbA1c in Class III obese Japanese patients after LSG.
Highlights
Bariatric surgery is one of the most effective treatments for Class III obese patients
At 12 months after laparoscopic sleeve gastrectomy (LSG) compared to pre-surgery, there was no significant difference between males and females in the change in body weight (BW), fat mass (FM), and %FM
The present study demonstrated that BW, FM, and %FM decreased, while % total muscle mass (MM) and %
Summary
Bariatric surgery is one of the most effective treatments for Class III obese patients. It significantly reduces obesity and lessens comorbid conditions, such as type-2 diabetes [1]. Among the surgical techniques utilized to promote weight loss, laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery and it is covered by health insurance in Japan [2,3]. LSG-associated body weight loss is effective for improving type-2 diabetes [2,3]. Various assessment techniques have been evaluated in previous studies and different patterns have been reported [4,5,6].
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