Audrey Auclair1,2, Julie Martin1,2, Marjorie Bastien1,2, Nadine Bonneville1,2, Laurent Biertho1,3, Simon Marceau1,3, Frédéric-Simon Hould1,3, Simon Biron1,3, Stéfane Lebel1,3, Odette Lescelleur1,3, Jean-Pierre Després1,3, Paul Poirier4,5. 1. Institut universitaire de cardiologie et de pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada. 2. Faculty of Pharmacy, Laval University, Québec City, QC, Canada. 3. Faculty of Medicine, Laval University, Québec City, QC, Canada. 4. Institut universitaire de cardiologie et de pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec City, QC, G1V 4G5, Canada. paul.poirier@criucpq.ulaval.ca. 5. Faculty of Pharmacy, Laval University, Québec City, QC, Canada. paul.poirier@criucpq.ulaval.ca.
Abstract
BACKGROUND: Severe obesity is often characterized by ectopic fat deposition, which is related to development of type 2 diabetes (T2D). Thus, resolution of T2D may not be linearly associated with weight loss. The importance of ectopic fat reduction after bariatric surgery and T2D resolution is uncertain. OBJECTIVE: The aim of this pilot study is to compare body composition and body fat distribution in severely obese patients with or without T2D after biliopancreatic diversion with duodenal switch (BPD-DS) surgery in relation to diabetes resolution. METHODS: Sixty-two severely obese patients were evaluated at baseline, 6, and 12 months. Of these, 40 patients underwent BPD-DS surgery. Anthropometric measurements and abdominal and mid-thigh computed tomography scans were performed at each visit. RESULTS: Before BPD-DS surgery, obese patients with T2D had higher weight as well as greater ectopic fat deposition in the abdomen and mid-thigh level than obese patients without T2D (p < 0.05). Resolution of T2D was 65 and 90 % at 6 and 12 months, respectively. No difference in body composition changes at 6 and 12 months could be found between patients without T2D, patients with T2D resolution, and patients who remained T2D. Resolution of T2D was associated with a greater absolute loss of visceral adipose tissue (VAT) in comparison to patients without T2D (-1175 ± 570 cm(3) vs. -729 ± 394 cm(3) at 6 months and -1647 ± 816 cm(3) vs. -1103 ± 422 cm(3) at 12 months; all p ≤ 0.05). CONCLUSION: Ectopic fat mobilization, particularly the absolute loss of VAT, may play a major role in T2D resolution following BPD-DS surgery, regardless of the amount of weight loss.
BACKGROUND: Severe obesity is often characterized by ectopic fat deposition, which is related to development of type 2 diabetes (T2D). Thus, resolution of T2D may not be linearly associated with weight loss. The importance of ectopic fat reduction after bariatric surgery and T2D resolution is uncertain. OBJECTIVE: The aim of this pilot study is to compare body composition and body fat distribution in severely obesepatients with or without T2D after biliopancreatic diversion with duodenal switch (BPD-DS) surgery in relation to diabetes resolution. METHODS: Sixty-two severely obesepatients were evaluated at baseline, 6, and 12 months. Of these, 40 patients underwent BPD-DS surgery. Anthropometric measurements and abdominal and mid-thigh computed tomography scans were performed at each visit. RESULTS: Before BPD-DS surgery, obesepatients with T2D had higher weight as well as greater ectopic fat deposition in the abdomen and mid-thigh level than obesepatients without T2D (p < 0.05). Resolution of T2D was 65 and 90 % at 6 and 12 months, respectively. No difference in body composition changes at 6 and 12 months could be found between patients without T2D, patients with T2D resolution, and patients who remained T2D. Resolution of T2D was associated with a greater absolute loss of visceral adipose tissue (VAT) in comparison to patients without T2D (-1175 ± 570 cm(3) vs. -729 ± 394 cm(3) at 6 months and -1647 ± 816 cm(3) vs. -1103 ± 422 cm(3) at 12 months; all p ≤ 0.05). CONCLUSION: Ectopic fat mobilization, particularly the absolute loss of VAT, may play a major role in T2D resolution following BPD-DS surgery, regardless of the amount of weight loss.
Entities:
Keywords:
Biliopancreatic diversion with duodenal switch surgery; Computed tomography scan; Ectopic fat; Severe obesity; Type 2 diabetes
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