Improvement of Glucose Metabolism following rapid weight loss after Bariatric Surgery and its impact on reduction of Visceral Abdominal Fat vs. Free Fat Muscle

Abstract Setting University Hospital, United States Objectives Body fat distribution is highly associated with metabolic disturbances. Skeletal muscle plays an important role in glucose metabolism as it serves as an important organ for glucose storage, in the form of glycogen. In fact, low muscle mass has been associated with metabolic syndrome, type 2 diabetes mellitus (T2DM), systemic inflammation, and decreased survival. The objective was to compare the relationship between visceral abdominal fat (VAF) and fat free mass (FFM) with the improved glucose metabolism after bariatric surgery. Methods A retrospective review was performed of all patients who underwent bariatric surgery between 2011 and 2017 at a university hospital in the United States. In severely obese patients with T2DM, we measured the VAF via abdominal computed tomography scan and we calculated the FFM preoperatively and at 12-month follow-up. Data collected included baseline demographics, perioperative parameters such as treatment for hypertension (HTN) and T2DM, body mass index (BMI), hemoglobin (HB) A1C, glucose, and lipid profile. Results A total of 25 patients met inclusion criteria. The average age was 52.5 + 11.6 years. The initial BMI was 41.41kg/m2±5.7 and the postoperative BMI was 31.7kg/m2 ± 6.9 (P Conclusions Bariatric surgery has demonstrated to be an effective treatment modality for severe obesity and T2DM. Our results suggest that at 12 months, there is a reduction in VAF and HB A1c without a significant loss of FFM. Further prospective studies are needed to better understand these findings.