title: Baseline abdominal lipid partitioning is associated with the metabolic response to bariatric surgery.
abstract: BACKGROUND
  The purpose of this study was to compare the effects of two bariatric procedures on abdominal lipid partitioning and metabolic response.
  
  
  METHODS
  Fifty-one patients (RYGB 31(11 M/20 F); (SG) 20(8 M/12 F)) who met the criteria of metabolic syndrome before the operation were followed following Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Visceral and subcutaneous abdominal fat depots were assessed by CT before, 6 months, and 12 months following the operation.
  
  
  RESULTS
  Patients undergoing both procedures did not differ in baseline body mass index (BMI) (42.84 ± 4.65 vs. 41.70 ± 4.68 kg/m(2)) or abdominal lipid depots. BMI at 12 months post-op was similar (29.44 ± 3.35 vs 30.86 ± 4.31 kg/m(2) for RYGB and SG, respectively). Both procedures led to a significant reduction in visceral and subcutaneous fat at 6 months (p < 0.001 for both). The visceral-to-subcutaneous fat ratio was comparable at 6 months vs. baseline yet was lower at 12 months vs. baseline for both procedures (p < 0.01). In patients who lost the diagnosis of metabolic syndrome, baseline visceral/subcutaneous fat was the only predictor of recovery (p < 0.005). No difference was detected between procedures in dynamics of abdominal fat depots or remission of cardiovascular risk factors.
  
  
  CONCLUSIONS
  RYGB and SG induce a similar effect on abdominal fat mobilization. The metabolic effects in individual patients are mostly determined by their baseline abdominal lipid partitioning.
authors.affiliation: Bariatric Surgery Service, Department of Surgery, Rabin Hospital, Petach Tiqkva, Israel.
authors.forename: Andrei
authors.initials: A
authors.lastname: Keidar
authors.forename: Liat
authors.initials: L
authors.lastname: Appelbaum
authors.forename: Chaya
authors.initials: C
authors.lastname: Schweiger
authors.forename: Karen
authors.initials: K
authors.lastname: Hershkop
authors.forename: Idit
authors.initials: I
authors.lastname: Matot
authors.forename: Naama
authors.initials: N
authors.lastname: Constantini
authors.forename: Jacob
authors.initials: J
authors.lastname: Sosna
authors.forename: Ram
authors.initials: R
authors.lastname: Weiss
mesh_terms: D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D050152:Intra-Abdominal Fat; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D050507:Subcutaneous Fat, Abdominal; D016896:Treatment Outcome