Abstract 18161: Quantity and Quality of Visceral Adipose Tissues: Their Roles into Comorbidities Related With Severe Obesity and Comorbidities Resolution After Bariatric Surgery
Introduction: Severe obesity is characterized by dysfunctional adipose tissue. Bariatric surgery induces significant and sustained weight loss and comorbidities resolution. Few studies assessed changes of adipose tissue quantity and quality in regards with comorbidities resolution.
Objectives: 1) To quantify and qualify visceral adipose tissue (VAT) vs. some comorbidities: obstructive sleep apnea (OSA), dyslipidemia (DLP), systemic hypertension (HTN) and type 2 diabetes (T2D) in severely obese patients. 2) To characterize the effect of bariatric surgery on VAT quantity and quality on comorbidities.
Methods: To assess VAT quantity (area, cm2) and quality (attenuation, Hounsfield Units, HU), 62 severely obese patients underwent abdominal computed tomography scan. A subgroup of 40 patients underwent biliopancreatic diversion with duodenal switch (BPD-DS) surgery and was re-evaluated after 12 months.
Results: In severely obese patients (n=62, women: 77%, age: 44.1±10.3 years, BMI: 45.8±5.3 kg/m2), prevalence of OSA, DLP, HTN and T2D were respectively 52%, 42%, 57% and 40%. VAT area was significantly higher in men and in patients with OSA, DLP, HTN and T2D when adjusted for sex (all p<0.001), despite no difference in VAT quality. Higher VAT area was associated with OSA (r=0.39), DLP (r=0.54), HTN (r=0.48) and T2D (r=0.46); all p<0.001. In the subgroup who underwent BPD-DS surgery (n=40, women: 75%, age: 44.4±10.5 years, BMI: 46.9±5.3 kg/m2), 12-month resolution of OSA, DLP, HTN and T2D were respectively 77%, 94%, 44% and 90%; all p<0.001. Area (332±98 to 118±75 cm2) and attenuation of VAT (-92.1±4.4 to -78.6±7.7 HU) were significantly improved after BPD-DS surgery. Reduction of VAT area was associated with resolution of T2D (r=0.31), HTN (r=0.32) and DLP (r=0.24); all p<0.05. Improvement of VAT quality was associated with resolution of HTN (r=0.44; p=0.005) and DLP (r=0.32; p=0.05).
Conclusions: Our data suggest that only VAT quantity is associated with some comorbidities of severe obesity. In contrast, both VAT quantity and quality changes are associated to comorbidities resolution following bariatric surgery. More studies are needed to better delineate the respective contribution of VAT quantity and quality.
Author Disclosures: A. Auclair: None. M. Piche: None. S. Marceau: None. L. Biertho: None. S. Lebel: None. F. Hould: None. S. Biron: None. O. Lescelleur: None. M. Rodriguez-Flores: None. J. Martin: None. M. Bastien: None. P. Poirier: None.
- © 2016 by American Heart Association, Inc.