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Degree of weight loss after surgery predicts reductions in insulin, glucose
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Long-term reductions in fasting insulin and glucose are better predicted with degree of weight loss rather than choice of bariatric surgery procedure, according to study findings.
Kajsa Sjöholm, PhD, of the University of Gothenburg in Sweden, and colleagues evaluated data from the Swedish Obese Subjects study on participants who completed the 2-year (n = 1,762) or 10-year (n = 1,216) follow-up to determine weight change-adjusted effects of gastric bypass compared with restrictive surgical procedures on long-term changes in fasting levels of glucose, insulin and homeostasis model assessment of insulin resistance (HOMA-IR).
Kajsa Sjöholm
Participants were divided into groups based on weight change (weight loss: > 30%, 20%-30% or 20%) and surgical method (banding, vertical banded gastroplasty and gastric bypass).
Weight loss of more than 30% was more common in the gastric bypass group (59%) compared with the other two methods (approximately 20%) after 2 years. Similarly, after 10 years, weight loss of more than 30% was more common in the gastric bypass group (25%) compared with the banding (14%) and vertical banded gastroplasty groups (8%).
Similar fasting levels of glucose, insulin and HOMA-IR were found for all surgery groups within given weight-change classes at 2 and 10 years. Glucose insulin and HOMA-IR reductions increased with increasing weight loss.
“Given the same degree of weight loss after bariatric surgery, there was no support for weight loss-independent benefits of [gastric bypass] over restrictive procedures on fasting glucose and insulin levels or HOMA-IR over 2 and 10 years,” the researchers wrote. “Hence, even though weight loss-independent effects that differ between surgical procedures are important for short-term remission, our results suggest that degree of weight loss is more important for long-term reductions in fasting insulin and glucose than choice of bariatric surgery procedure.” – by Amber Cox
Disclosure: Sjöholm reports stock ownership in Pfizer. Please see the full study for a list of all other authors’ relevant financial disclosures.
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