title: Differential Effects of Bariatric Surgery Versus Exercise on Excessive Visceral Fat Deposits.
abstract: The aim of the present study was to compare differential impacts of bariatric surgery and exercise-induced weight loss on excessive abdominal and cardiac fat deposition.Excessive fat accumulation around the heart may play an important role in the pathogenesis of cardiovascular disease. Recent evidences have suggested that bariatric surgery results in relatively less decrease in epicardial fat compared with abdominal visceral fat and paracardial fat.Sixty-four consecutive overweight or obese subjects were enrolled in the study. Clinical characteristics and metabolic profiles were recorded. The volumes of abdominal visceral adipose tissue (AVAT), abdominal subcutaneous adipose tissue (ASAT), epicardial (EAT), and paracardial adipose tissue (PAT) were measured by computed tomography in the bariatric surgery group (N = 25) and the exercise group (N = 39) at baseline and 3 months after intervention. Subjects in both the surgery and exercise groups showed significant reduction in body mass index (15.97%, 7.47%), AVAT (40.52%, 15.24%), ASAT (31.40, 17.34%), PAT (34.40%, 12.05%), and PAT + EAT (22.31%, 17.72%) (all P < 0.001) after intervention compared with baseline. In both the groups, the decrease in EAT was small compared with the other compartments (P < 0.01 in both groups). Compared with the exercise group, the surgery group had greater loss in abdominal and cardiac visceral adipose tissue (AVAT, ASAT, PAT, EAT+PAT) (P < 0.001), but lesser loss in EAT (P = 0.037).Compared with the exercise group, bariatric surgery results in significantly greater percentage loss of excessive fat deposits except for EAT. EAT, but not PAT, was relatively preserved despite weight reduction in both the groups. The physiological impact of persistent EAT deserves further investigation.
authors: From the Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (F-ZW, Y-LH, Y-CW, M-TW); Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan (F-ZW, Y-LH, M-TW); Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan (F-ZW, Y-LH, M-TW); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX (CCW); Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (H-JP); Bariatric & Metabolic International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan (C-KH); and Department of Radiology, E-Da Hospital, Kaohsiung, Taiwan (L-RY).
authors: Fu-Zong
authors: FZ
authors: Wu
authors: Yi-Luan
authors: YL
authors: Huang
authors: Carol C
authors: CC
authors: Wu
authors: Yen-Chi
authors: YC
authors: Wang
authors: Hsiang-Ju
authors: HJ
authors: Pan
authors: Chin-Kun
authors: CK
authors: Huang
authors: Lee-Ren
authors: LR
authors: Yeh
authors: Ming-Ting
authors: MT
authors: Wu
mesh_terms: D050154:Adiposity; D000328:Adult; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology / Q000628:therapy*; D010496:Pericardium / Q000473:pathology; D050507:Subcutaneous Fat, Abdominal / Q000473:pathology; D015431:Weight Loss