title: Changes in body composition and insulin sensitivity in severely obese subjects after laparoscopic adjustable silicone gastric banding (LASGB).
abstract: BACKGROUND
  Laparoscopic adjustable silicone gastric banding (LASGB) is a viable therapeutic approach to achieve stable body weight reduction in severe obesity. The aim of this study was to evaluate body composition and metabolic features in morbidly obese patients before and after LASGB.
  
  
  METHODS
  There were 15 severely obese patients (Ob) (M/F: 4/11; mean age: 32.5 +/- 3.8 years) and 16 age-and sex-matched healthy lean controls (C) (M/F: 4/12; mean age: 39.5 +/- 2 years). Body mass index (BMI), waist circumference, waist-to-hip ratio, blood pressure, lipid profile, serum glucose and insulin during OGTT, and HOMA-IR were evaluated in all subjects. Body composition and fat distribution were measured using dual energy X-ray absorptiometry (DEXA). Patients were assessed before and six months after LASGB.
  
  
  RESULTS
  The obese subjects showed several metabolic alterations. There were also positive correlations between waist, fat mass (FM), and HOMA-IR at baseline. After LASGB, mean BMI fell from 42.2 kg/m2 to 33.2 kg/m2; waist circumference and abdominal FM% decreased significantly. FM% declined, whereas FFM% increased. The ratio of FM loss to FFM loss was 3.7:1. Serum glucose and insulin levels during OGTT diminished slightly after weight loss and triglyceride levels fell dramatically. After LASGB, fasting insulin and HOMA-IR declined.
  
  
  RESULTS
  LASGB induced a significant improvement in insulin sensitivity and a redistribution of body composition with a relative increase of FFM.
authors.affiliation: Division of Endocrinology, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Gabriella G M
authors.initials: GG
authors.lastname: Garrapa
authors.forename: Paola
authors.initials: P
authors.lastname: Canibus
authors.forename: Cristina
authors.initials: C
authors.lastname: Gatti
authors.forename: Milena
authors.initials: M
authors.lastname: Santangelo
authors.forename: Frederica
authors.initials: F
authors.lastname: Frezza
authors.forename: Francesco
authors.initials: F
authors.lastname: Feliciotti
authors.forename: Marco
authors.initials: M
authors.lastname: Boscaro
authors.forename: Emanuela
authors.initials: E
authors.lastname: Faloia
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007333:Insulin Resistance; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000378:metabolism / Q000628:therapy*; D012828:Silicones; D013270:Stomach / Q000601:surgery*; D015431:Weight Loss
chemical_list: D012828:Silicones