Metabolic risk factors in formerly obese women--effects of a pronounced weight loss by gastric band operation compared with weight loss by diet alone.
OBJECTIVE
The aim of the present study was to evaluate differences in the metabolic risk profile in formerly obese women, in whom a significant weight loss was obtained by Swedish adjustable gastric band (SAGB) operation or by diet alone.


METHODS
A total of 40 patients (24 after SAGB and 16 after diet) participated in the study. Clinical data, including body mass index (BMI), waist-to-hip ratio, body fat content and blood pressure values, as well as laboratory results [fasting glucose, insulin, homeostasis model assessment (HOMA) index, leptin, lipid values and markers of subclinical inflammation] were evaluated before a planned abdominoplastic operation.


RESULTS
Patients in the SABG group had lost a significantly greater amount of weight (52.7 +/- 10.0 kg) compared with the diet group (20.0 +/- 11.5 kg; p < 0.001), and the percent excess weight loss was 69.1 +/- 11.4 in the SAGB group and 54.5 +/- 17.7 (p < 0.040) in the diet group. Before the abdominoplastic operation neither the mean BMI nor the percentage of fat mass revealed a significant difference between the groups. Fasting insulin (6.1 +/- 3.0 microU/ml) and the HOMA index (1.4 +/- 0.7) as a measure of insulin resistance were significantly lower in the SAGB than in the diet group (fasting insulin: 8.2 +/- 3.8 microU/ml; p < 0.048; HOMA index: 2.0 +/- 1.0; p < 0.031). Swedish adjustable gastric band patients showed significantly lower plasma leptin levels (9.4 +/- 10.8 ng/ml) than the dietary-treated patients (13.9 +/- 9.6 ng/ml; p < 0.014), while tumour necrosis factor-alpha serum levels were increased in the SAGB group (17.6 +/- 7.3 pg/ml) compared with the diet group (11.9 +/- 0.49 pg/l; p < 0.048).


CONCLUSIONS
The extensive weight loss in formerly obese women after SAGB operation was paralleled by a favourable metabolic profile indicating a higher degree of insulin sensitivity than in women after a successful, but less pronounced weight loss by diet alone.
Ritt
M
M
Department of Internal Medicine, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
Piza
H
H
Rhomberg
M
M
Aigner
F
F
Lechleitner
M
M
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D004038:Diet, Reducing; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D015431:Weight Loss
D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha