Effects of bariatric surgery on metabolic and nutritional parameters in severely obese Korean patients with type 2 diabetes: A prospective 2-year follow up.
OBJECTIVE
Little is known about the long-term effects of Roux-en-Y gastric bypass (RYGB) in severely obese Asian individuals.


METHODS
A total of 33 severely obese patients with type 2 diabetes underwent RYGB. All patients were followed up for 2 years. Visceral and abdominal subcutaneous fat areas were assessed using computed tomography (CT) before, and 12 and 24 months after RYGB. The muscle attenuation (MA) of paraspinous muscles observed by CT were used as indices of intramuscular fat.


RESULTS
The mean percentage weight loss was 22.2 ± 5.3% at 12 months, and 21.3 ± 5.1% at 24 months after surgery. Compared with the baseline values, the visceral fat area was 53.6 ± 17.1% lower 24 months after surgery, and the abdominal subcutaneous fat area was 32.7 ± 16.1% lower 24 months after surgery. The MA increased from 48.7 ± 10.0 at baseline to 52.2 ± 8.9 (P = 0.009) 12 months after surgery. The MA after the first 12 months maintained changes until 24 months. Triglycerides and free fatty acids were reduced after surgery, whereas the high-density lipoprotein cholesterol levels were increased significantly after surgery. At the last follow-up visit, 18 patients (55%) had diabetes remission. The percentage of iron and vitamin D deficiency was 30% and 52%, respectively.


CONCLUSIONS
We found that patients subjected to RYGB had significant sustained reductions in visceral and intramuscular fat. There were durable improvements in the cardiometabolic abnormalities without any significant comorbidities. However, there were mild nutritional deficiencies in these patients despite daily supplementation with multivitamins and minerals.
Department of Internal Medicine The Catholic University of Korea Seoul Korea.
Mee Kyoung
MK
Kim
Department of Surgery The Catholic University of Korea Seoul Korea.
Wook
W
Kim
Department of Internal Medicine The Catholic University of Korea Seoul Korea.
Hyuk-Sang
HS
Kwon
Department of Internal Medicine The Catholic University of Korea Seoul Korea.
Ki-Hyun
KH
Baek
Department of Surgery The Catholic University of Korea Seoul Korea.
Eung Kook
EK
Kim
Department of Internal Medicine The Catholic University of Korea Seoul Korea.
Ki-Ho
KH
Song
Bariatric surgery; Intramuscular fat; Visceral fat