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Clinical Studies and Practice

Dissociation of body mass index, excess weight loss and body fat percentage trajectories after 3 years of gastric bypass: relationship with metabolic outcomes

International Journal of Obesity volume 41, pages 1379–1387 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

Body weight, body mass index (BMI) and excess weight loss (EWL) are the most frequently used measures to analyse bariatric surgery outcomes. However, these measurements do not provide accurate information on body composition (BC) with body fat (BF), importantly determining the levels of cardiometabolic risk factors. Our aim was to analyse the evolution of BC after Roux-en-Y Gastric Bypass (RYGB) and its influence on the changes of cardiometabolic risk factors in comparison to BMI and EWL.

Subjects/Methods:

A group of 81 obese Caucasian patients (19 males/62 females) aged 44.9±1.3 years undergoing RYGB between January 2006 and December 2011 was prospectively followed up for a period of 3 years. BC was determined by air-displacement plethysmography. Visceral adiposity, physical activity and cardiometabolic risk factors were measured.

Results:

BF was markedly (P<0.001) reduced after the first year, increasing progressively during the second and third years after RYGB, following a different trajectory than body weight, BMI and EWL that decreased up to the second year post surgery. Markers of glucose homeostasis decreased during the first month and continued to decrease during the first year (P<0.05), remaining stabilised or slightly increased between the second and third years following RYGB. However, markers of lipid metabolism decreased (P<0.05) markedly during the first 12 months, increasing thereafter in parallel to the changes observed in BC, with the exception of high-density lipoprotein-cholesterol, which increased progressively throughout the whole period analysed.

Conclusions:

The adverse switch in the changes in BC between the first and the second years after RYGB may underlie the changes observed in cardiometabolic risk factors. Tracking of adiposity during the follow-up of bariatric/metabolic surgery yields clinically relevant information to better identify patients in need of increased lifestyle advice or treatment intensification.

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Acknowledgements

We gratefully acknowledge the valuable collaboration of all the members of the Nutrition Unit for their technical support. We also wish to thank all subjects who participated in this study. This work was supported by the project grant PI16/01217, integrated in the Plan Estatal I+D+I 2013-16 from the Spanish Instituto de Salud Carlos III—Subdirección General de Evaluación y Fomento de la investigación and FEDER. CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN) is an initiative of the Instituto de Salud Carlos III, Spain.

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Authors and Affiliations

  1. Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain

    J Gómez-Ambrosi, V Catalán, A Rodríguez, B Ramírez & G Frühbeck

  2. Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, Spain

    J Gómez-Ambrosi, V Valentí, C Silva, V Catalán, A Rodríguez, B Ramírez, R Moncada, J Escalada, J Salvador & G Frühbeck

  3. Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain

    J Gómez-Ambrosi, V Valentí, C Silva, V Catalán, A Rodríguez, B Ramírez, R Moncada & G Frühbeck

  4. Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain

    P Andrada, C Silva, J Escalada, J Salvador & G Frühbeck

  5. Department of Surgery, Clínica Universidad de Navarra, Pamplona, Spain

    V Valentí & F Rotellar

  6. Department of Anaesthesia, Clínica Universidad de Navarra, Pamplona, Spain

    R Moncada

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  1. J Gómez-Ambrosi
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Correspondence to J Gómez-Ambrosi or G Frühbeck.

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G Frühbeck has served as an advisor for Novo Nordisk Pharmaceuticals. The remaining authors declare no conflict of interest.

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Gómez-Ambrosi, J., Andrada, P., Valentí, V. et al. Dissociation of body mass index, excess weight loss and body fat percentage trajectories after 3 years of gastric bypass: relationship with metabolic outcomes. Int J Obes 41, 1379–1387 (2017). https://doi.org/10.1038/ijo.2017.134

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