Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Surg Obes Relat Dis. 2021 May;17(5):933-938. doi: 10.1016/j.soard.2021.01.031. Epub 2021 Feb 2.
Body fat distribution is highly associated with metabolic disturbances. Skeletal muscle plays an important role in glucose metabolism, as it serves as an important organ for glucose storage in the form of glycogen. In fact, low muscle mass has been associated with metabolic syndrome, type 2 diabetes (T2D), systemic inflammation, and decreased survival.
To compare the relationship between visceral abdominal fat (VAF) and fat free mass (FFM) with the improved glucose metabolism after bariatric surgery.
University hospital, United States.
A retrospective review was performed of all patients who underwent bariatric surgery between 2011 and 2017 at a university hospital in the United States. In severely obese patients with T2D, we measured the VAF via abdominal computed tomography scan and we calculated the FFM preoperatively and at a 12-month follow-up. Data collected included baseline demographic characteristics and perioperative parameters, such as treatment for hypertension (HTN) and T2D, body mass index (BMI), glycated hemoglobin (HbA1C), glucose, and lipid profile.
A total of 25 patients met the inclusion criteria. The average age was 52.5 ± 11.6 years. The initial BMI was 41.41 ± 5.7 kg/m and the postoperative BMI was 31.7 ± 6.9 kg/m (P < .0001). The preoperative VAF volume was 184.6 ± 90.2 cm and the postoperative VAF volume was 93.8 ± 46.8 cm at the 12-month follow-up (P < .0001). The preoperative FFM was 55.2 ± 11.4 kg and the postoperative FFM was 49.1 ± 12 kg (P < .072). The preoperative HbA1C was 5.8% ± .9%, which decreased postoperatively to 5.3% ± .4% at the 12-month follow-up (P < .013).
Bariatric surgery has been demonstrated to be an effective treatment modality for severe obesity and T2D. Our results suggest that at 12 months, there is a reduction in VAF and HbA1C without a significant loss of FFM. Further prospective studies are needed to better understand these findings.
体脂分布与代谢紊乱高度相关。骨骼肌在葡萄糖代谢中起着重要作用，因为它是葡萄糖以糖原形式储存的重要器官。事实上，肌肉量低与代谢综合征、2 型糖尿病（T2D）、全身炎症和生存率降低有关。
比较内脏腹部脂肪（VAF）和去脂体重（FFM）与减重手术后改善的葡萄糖代谢之间的关系。
美国大学医院。
对 2011 年至 2017 年在美国一所大学医院接受减重手术的所有患者进行回顾性审查。在患有 T2D 的严重肥胖患者中，我们通过腹部计算机断层扫描测量 VAF，并在术前和 12 个月随访时计算 FFM。收集的数据包括基线人口统计学特征和围手术期参数，如高血压（HTN）和 T2D 的治疗、体重指数（BMI）、糖化血红蛋白（HbA1C）、血糖和血脂谱。
共有 25 名患者符合纳入标准。平均年龄为 52.5 ± 11.6 岁。初始 BMI 为 41.41 ± 5.7 kg/m，术后 BMI 为 31.7 ± 6.9 kg/m（P <.0001）。术前 VAF 体积为 184.6 ± 90.2 cm，术后 12 个月随访时 VAF 体积为 93.8 ± 46.8 cm（P <.0001）。术前 FFM 为 55.2 ± 11.4 kg，术后 FFM 为 49.1 ± 12 kg（P <.072）。术前 HbA1C 为 5.8% ±.9%，术后 12 个月随访时降至 5.3% ±.4%（P <.013）。
减重手术已被证明是治疗严重肥胖和 T2D 的有效方法。我们的结果表明，在 12 个月时，VAF 和 HbA1C 降低，而 FFM 无明显丢失。需要进一步的前瞻性研究来更好地了解这些发现。
