Short-term effects of obesity surgery versus low-energy diet on body composition and tissue-specific glucose uptake: a randomised clinical study using whole-body integrated 18F-FDG-PET/MRI
Authors' conclusion
The short-term metabolic effects seen 4 weeks after OS are not explained by loss of body fat alone. Thus OS, but not LCD, led to reductions in fasting plasma glucose and insulin resistance as well as to distinct changes in insulin-stimulated glucose fluxes to different tissues. Such effects may contribute to the prevention or reversal of type 2 diabetes following OS. Moreover, the full effects on whole-body insulin resistance and plasma glucose require a longer time than 4 weeks.
Study context
- Population
- Individuals with obesity but not diabetes on a waiting list for obesity surgery (OS)
- Participants
- 15 vs 9
- Comparison
- Obesity surgery vs LCD
- OSn = 15
- LCDn = 9reference
- Primary endpoint
- HOMA-IR change
- Follow-up
- 4 weeks
Methodological detailsparallel group, no blinding, sealed envelopes
- Parallel group
- No blinding
- Sealed envelopes
Primary result
As reported in the abstract
| Group | Value | p |
|---|---|---|
| OS | −26.3% (CI −49.5–-3.0) | p=0.009 |
| LCD | −20.9% (CI −58.2–16.5) |
Value
OS−26.3% (CI −49.5–-3.0)
LCD−20.9% (CI −58.2–16.5)
p
OSp=0.009
LCD— not stated in the abstract
Further findings
Mean, kg
| Outcome | OS | LCD |
|---|---|---|
| Body weight change · 1 month | −7.7 (SD 1.4) | −7.4 (SD 2.2) |
- Body weight change — Similar reductions in adipose tissue volume and liver fat content in both groups
- 7%; 2% units
Lipids, fasting glucose and insulin
- Similar reductions in TG and LDL-C in both groups
- FPG and insulin significantly reduced only after OS
OGTT glucose AUC
- Increase in glucose AUC in OS group, not in LCD group
- 20%
PET-derived tissue glucose uptake during hyperinsulinaemia
- Only OS: increased skeletal muscle uptake, reduced heart and abdominal adipose tissue uptake
- Liver and brain uptake unchanged after surgery or LCD
- Whole-body glucose disposal and endogenous glucose production not significantly affected
Original publication
Short-term effects of obesity surgery versus low-energy diet on body composition and tissue-specific glucose uptake: a randomised clinical study using whole-body integrated 18F-FDG-PET/MRI. Diabetologia. Published 24 April 2024. doi:10.
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