Relationships between computed tomography-assessed density, abdominal fat volume, and glucose metabolism after sleeve gastrectomy in Japanese patients with obesity

Endocr J. 2019 Jul 28;66(7):605-613. doi: 10.1507/endocrj.EJ18-0543. Epub 2019 Apr 23.

Abstract

In this study, we investigated the relationships between body weight (BW), computed tomography (CT)-assessed abdominal adipose tissue, and the glycemic metabolic profile in obese Japanese patients following laparoscopic sleeve gastrectomy (LSG). This study analyzed adipose tissue compartments using CT methods before and 1 year after LSG. Thirty obese patients were studied, and variables measured included visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), density of VAT (VAT-D), and density of SAT (SAT-D). We also examined the parameters in patients according to whether they had type-2 diabetes (T2DM). LSG induced significant losses in BW, SAT, and VAT after LSG. Additionally, SAT-D and VAT-D both increased and fasting plasma glucose (FPG) and HbA1c, but not C-peptide, decreased after surgery. ΔSAT and ΔVAT were positively related, and ΔSAT-D and ΔVAT-D were negatively related to ΔBW and/or FPG. Furthermore, a multivariate regression model showed that total BW loss (TBWL) was closely related to ΔSAT (β = 0.84; p < 0.001) and ΔVAT-D (β = -0.45; p < 0.05) and improvement of FPG was related to ΔVAT (β = 0.61; p < 0.05) after LSG. Finally, ΔFPG was correlated with ΔVAT in 16 T2DM patients (r = 0.58; p < 0.05) but not in non-T2DM patients. TBWL was related to ΔSAT and ΔVAT-D, and improvement of FPG was related to ΔVAT in obese Japanese patients after LSG.

Keywords: Computed tomography; Laparoscopic sleeve gastrectomy; Obesity; Subcutaneous adipose tissue; Visceral adipose tissue.

MeSH terms

  • Abdominal Fat / diagnostic imaging*
  • Abdominal Fat / metabolism
  • Abdominal Fat / pathology*
  • Adult
  • Blood Glucose / metabolism*
  • Energy Metabolism / physiology
  • Female
  • Gastrectomy / methods
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging*
  • Intra-Abdominal Fat / metabolism
  • Intra-Abdominal Fat / pathology*
  • Japan
  • Male
  • Middle Aged
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / pathology
  • Obesity, Morbid / surgery*
  • Organ Size
  • Retrospective Studies
  • Subcutaneous Fat / diagnostic imaging
  • Subcutaneous Fat / metabolism
  • Subcutaneous Fat / pathology
  • Tomography, X-Ray Computed

Substances

  • Blood Glucose