Effect of laparoscopic Roux-en-Y gastric bypass on body composition and insulin resistance in Chinese patients with type 2 diabetes mellitus.
BACKGROUND
This study aims to assess the effect of laparoscopic Roux-en-Y gastric bypass (LRYGB) on body composition, fat distribution, and insulin resistance (IR) in Chinese type 2 diabetes mellitus (T2DM) patients.


METHODS
Eighteen patients with T2DM were studied before and 3 months post LRYGB. Fasting plasma glucose (FPG), fasting insulin (FINS), and triglyceride (TG) were measured. IR index was determined using the homeostasis model assessment of insulin resistance (HOMA-IR). Body composition and fat distribution were measured by dual-energy X-ray absorptiometry (DXA). Fat mass (FM), muscle mass (MM), bone mineral content (BMC), and percent fat mass (%FM) at the whole body and five body regions including the arms, legs, trunk, android, and gynoid were obtained from DXA scans.


RESULTS
HOMA-IR decreased from 5.02 at baseline to 1.43 3 months post LRYGB (p < 0.05). There was significant decrease in total and regional body mass and body fat (all p < 0.05). A significant reduction was observed in %FM at every tested body region (all p < 0.05). There was more fat mass loss (31.03 %) in android region than any other tested body region. Preoperative android %FM was significantly correlated with IR (r = 0.49, p < 0.05). Changes in android FM showed significant correlations with changes in IR, FPG, FINS, and TG (r = 0.54, 0.64, 0.54, and 0.67, respectively; all p < 0.05).


CONCLUSIONS
Body composition in Chinese T2DM patients is rebalanced after LRYGB. Reduction of central obesity can result in improvement of IR, and android fat distribution may be a good indicator of postoperative benefits for LRYGB.
Department of General Surgery, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, People's Republic of China.
Weizheng
W
Li
Liyong
L
Zhu
Zhaohui
Z
Mo
Xiangwu
X
Yang
Guohui
G
Wang
Pengzhou
P
Li
Juan
J
Tan
Fei
F
Ye
Jeff
J
Strain
Ibrahim
I
Im
Shaihong
S
Zhu
D015502:Absorptiometry, Photon; D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D044466:Asian People; D001823:Body Composition; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery; D056128:Obesity, Abdominal / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D016896:Treatment Outcome; D055105:Waist Circumference; D049629:Waist-Hip Ratio
D007328:Insulin