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Long-term metabolic, adipose tissue improvements present after RYGB

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November 23, 2016

Despite weight regain after bariatric surgery, long-term insulin sensitivity and adipose phenotypes remain improved in women with obesity, study findings show.

Peter Arner, MD, PhD, professor in the department of medicine at Karolinska University Hospital, Karolinska Institutet in Stockholm, and colleagues evaluated data from 49 women with obesity before and 2 and 5 years after Roux-en-Y gastric bypass (RYGB) to determine the effect of the surgery on changes in adipose function. BMI- and age-matched controls (n = 30) were compared with 30 participants at the 5-year follow-up.

At 2 years after surgery, BMI significantly decreased from 43 kg/m2 to 29 kg/m2; reductions also occurred for waist-to-hip ratio, hip and waist circumferences, all measures of regional fat depots, serum adiponectin, fat cell size and lipolysis in vivo and in vitro. BMI increased by approximately 2.5 kg/m2 at 5 years after surgery and an increase occurred in fat accumulation in all measured regions. There was also a significant deterioration of homeostasis model of assessment for insulin resistance (HOMA-IR) and minor changes in the lipid profile, but no changes in serum adiponectin were observed.

At 5 years, RYGB participants had better insulin sensitivity, lipid profiles and higher adiponectin levels compared with controls

“RYGB surgery in obese women leads to long-term improvements in metabolic and [white adipose tissue] phenotype beyond the normal state despite weight regain,” the researchers wrote. “These changes involve an attenuated inflammatory response, high adiponectin secretion, as well as development of [white adipose tissue] hyperplasia. The molecular mechanisms that mediate the transition into a ‘super-normal’ [white adipose tissue] after bariatric surgery remain to be established but could be related to changes in the expression of specific [white adipose tissue] genes, as recently observed in metabolically healthy obese individuals after overfeeding.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.