Body fat percentage changes predict diabetes remission after bariatric surgery

Changes in body fat percentage (BFP) are significantly associated with diabetes remission after bariatric surgery, suggests a study, noting that baseline fat-free mass index (FFMI) is vital for BFP changes.

In addition, a low initial body mass index (BMI) is linked to a smaller decrease in BFP and a greater FFMI loss following bariatric surgery.

A total of 203 diabetic patients who underwent Roux-en-Y gastric bypass were analysed. The researchers measured body composition using a gold standard-derived predictive equation and magnetic resonance imaging. Body composition changes were calculated as 100 x (baseline value – follow-up value)/baseline value. Results were verified in a laparoscopic sleeve gastrectomy cohort with 311 patients.

Patients who achieved diabetic remission had a higher baseline FFMI and showed the most significant changes in BFP (p<0.001) compared with those who had no remission. Comparative analyses revealed that BFP changes were a better predictor of short- and long-term diabetes remission than BMI changes.

In linear regression analysis, FFMI was the most important baseline variable associated with BFP changes (p<0.001).  In addition, baseline BMI showed a positive association with changes in BFP and a negative correlation with changes in FFMI. Of note, similar findings were observed in the laparoscopic sleeve gastrectomy cohort.

“BFP changes determine diabetes remission after bariatric surgery, and baseline FFMI is crucial for BFP changes,” the researchers said. “A low initial BMI is associated with a smaller BFP reduction and greater FFMI loss after bariatric surgery.”