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01 November 2005

Changes in Body Composition and Insulin Sensitivity in Severely Obese Subjects After Laparoscopic Adjustable Silicone Gastric Banding (LASGB).

Gabriella Garrapa, Paola Canibus, Cristina Gatti, Milena Santangelo, Federica Frezza, Francesco Feliciotti, Marco Boscaro, Emanuela Faloia

DOI: 10.12659/MSM.430365

Med Sci Monit 2005; 11(11): CR522-528

Abstract

Background: Laparoscopic adjustable silicone gastric banding (LASGB) isa viable therapeutic approach to achieve stable body weight reduction in severe obesity. The aim of thisstudy was to evaluate body composition and metabolic features in morbidly obese patients before and afterLASGB. Material/Methods: There were 15 severely obese patients (Ob) (M/F: 4/11; mean age: 32.5+/-3.8years) and 16 age- and sex-matched healthy lean controls (C) (M/F: 4/12; mean age: 39.5+/-2 years). Bodymass index (BMI), waist circumference, waist-to-hip ratio, blood pressure, lipid profile, serum glucoseand insulin during OGTT, and HOMA-IR were evaluated in all subjects. Body composition and fat distributionwere measured using dual energy X-ray absorptiometry (DEXA). Patients were assessed before and six monthsafter LASGB. Results: The obese subjects showed several metabolic alterations. There were also positivecorrelations between waist, fat mass (FM), and HOMA-IR at baseline. After LASGB, mean BMI fell from 42.2kg/m(2) to 33.2 kg/m(2); waist circumference and abdominal FM% decreased significantly. FM% declined,whereas FFM% increased. The ratio of FM loss to FFM loss was 3.7:1. Serum glucose and insulin levelsduring OGTT diminished slightly after weight loss and triglyceride levels fell dramatically. After LASGB,fasting insulin and HOMA-IR declined. Conclusions: LASGB induced a significant improvement in insulinsensitivity and a redistribution of body composition with a relative increase of FFM.

Keywords: Anthropometry, Absorptiometry, Photon, Body Composition, Gastroplasty - methods, Insulin Resistance, Laparoscopy, Obesity, Morbid - therapy, Silicones, Stomach - surgery, Weight Loss

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750