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VISCERAL ADIPOSE TISSUE (VAT) PREDICTS %TBWL FOLLOWING BARIATRIC SURGERY: INSIGHTS FROM BIOIMPEDANCE ANALYSIS
Mhd Manar Al Jawish
*, Tarek Odah, Yuting Huang, Jiang Zou, Kimberly Hall, Enrique F. Elli, Vivek Kumbhari, Dilhana Badurdeen
Mayo Clinic, Jacksonville, FL
IntroductionWeight loss outcomes vary widely between individuals, with visceral adipose tissue (VAT) playing a crucial role in influencing metabolic improvements after interventions such as bariatric surgery. VAT, primarily located in the abdominal cavity, is distinct from subcutaneous fat (SCAT) and is associated with higher risks of metabolic dysfunction due to its secretion of pro-inflammatory cytokines like TNF-? and IL-6. Higher VAT levels at follow-up after bariatric surgery have been linked to lower remission rates and increased incidence of diabetes, hypertension, and dyslipidemia. The aim of this study is to identify predictors of weight loss after bariatric surgery by utilizing bioimpedance analysis to assess body composition and related factors.
MethodsWe conducted a retrospective analysis of 105 patients who underwent RYGB or sleeve gastrectomy between 2019 to 2023. The primary outcome was TBWL with independent variables including age (<50 years vs ?50 years), gender, procedure type, resting energy expenditure (REE), visceral adipose tissue (VAT), skeletal muscle mass and preoperative weight. Linear regression was used to assess the associations between TBWL and the predictors.
ResultsA total of 105 patients were included in the analysis, with an average age of 51.1 ± 13.1 years. The cohort was 79.1% white and 82.9% female
. VAT, procedure type, and preoperative weight were significantly associated with TBWL after bariatric surgery. A 1 L increase in VAT was associated with a 1.87% decrease in TBWL (coefficient = ?1.87, CI ?3.32 to ?0.42, p=0.012), undergoing sleeve gastrectomy (vs. RYGB) was associated with a 5.29% lower TBWL (coefficient = ?5.29, CI ?10.38 to ?0.21, p=0.041), and preoperative weight was associated with a 0.18% increase in TBWL per pound (coefficient = 0.18, CI 0.02 to 0.34, p=0.029). Age (<50 years vs ?50 years) was borderline significant, with a 4.36% decrease in TBWL (coefficient = ?4.36, CI ?8.75 to 0.18, p=0.051). Other variables, including gender, REE, and skeletal muscle mass, were not significantly associated with TBWL.
Conclusion:Bariatric surgery improves total body weight loss (TBWL), with VAT, procedure type, and preoperative weight identified as key predictors of outcomes. These results highlight the importance of tailoring surgical interventions based on patient-specific factors, including body composition and preoperative characteristics, to optimize metabolic and weight loss outcomes.
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