Insulin Resistance, Metabolic Risk Factors, and Body Composition 6 Months after Laparoscopic Gastric Banding Surgery

Abstract

The purposes of this study were to determine overall and gender-related effects of laparoscopic gastric banding (LGB) on body composition, insulin resistance, and metabolic risk factors. 19 patients (8 men, 11 women) were evaluated at baseline (T1) and 6 months after LGB (T2) for body composition, blood pressure, metabolic risk factors, and Homeostasis model assessment-insulin resistance (HOMA-IR). At T1, men had higher total visceral adipose mass than women (8.6±0.8 vs 5.2±0.5 kg, respectively, p≤0.01), and tended to have a greater body weight and waist/hip ratio (p≤0.10). HOMA-IR was 2.86±0.4 and 9 of 19 subjects had scores >2.5. At T2, all measures of body composition were significantly improved, although BMI was still 36.3±1.3 kg/m2. HOMA-IR declined to 1.33±0.2 and only 2 subjects had scores above 2.5. Reduced HOMA-IR was due to reduced fasting insulin with no change in fasting glucose. At T2, systolic blood pressure, cardiac CRP, and fasting fatty acids were reduced while ApoA1 was increased. Only the change in ApoA1 displayed gender differences, with women having greater increases than men (p≤0.01). Plasma total and HDL cholesterol, and ApoB were not altered at T2. Thus, there were significant improvements in risk factor profile 6 months after LGB, despite ongoing obesity. Improvements in most risk factors were not dependent on gender. Support by CDC H75/CCH224064, NIH 64913.