Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y gastric bypass in adolescents

Andrew J. Beamish; Olivia H. Dengel; Elise F. Palzer; Eva Gronowitz; Aaron S. Kelly; Donald R. Dengel; Kyle D. Rudser; Markus Brissman; Torsten Olbers; Jovanna Dahlgren; Carl Erik Flodmark; Claude Marcus; Justin R. Ryder

doi:10.1016/j.soard.2023.04.326

Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y gastric bypass in adolescents

Andrew J. Beamish, Olivia H. Dengel, Elise F. Palzer, Eva Gronowitz, Aaron S. Kelly, Donald R. Dengel, Kyle D. Rudser, Markus Brissman, Torsten Olbers, Jovanna Dahlgren, Carl Erik Flodmark, Claude Marcus, Justin R. Ryder

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Roux-en-Y gastric bypass (RYGB) among adolescents with obesity results in significant weight loss; however, depot-specific changes have been understudied. Objective: We hypothesized that visceral adipose tissue (VAT) reduction in adolescents undergoing RYGB would be greater than other depots and associated with improvement in cardiometabolic risk factors. Setting: Three specialized treatment centers in Sweden. Methods: Fifty-nine adolescents underwent dual x-ray absorptiometry before surgery and at 1, 2, and 5 years after RYGB. Changes in body composition in multiple depots (total fat, lean body, gynoid fat, android fat, subcutaneous adipose tissue, and VAT) and cardiometabolic risk factors were assessed using multiple linear regression analysis and generalized estimating equations adjusting for age, sex, and baseline risk factor levels. Data are presented as percent change (95% CI) with regression models showing slopes and estimated P values. Results: At 1 year post-RYGB, a significant reduction was observed across all body composition measures (P <.001) with the greatest reduction observed in VAT (–65.1% [–68.7, –61.8]). From year 1 to 5 years post-RYGB, a regain was observed in all depots except lean body mass (1.2% [.3, 2.7], P =.105). A sex-specific difference in overall trajectories was only observed in lean body mass with males consistently having higher mean levels. Change in VAT at 1 year correlated with change in triglycerides (slope:.21 mg/dL/kg, P =.034) and fasting plasma insulin (slope: 44 pmol/L/kg, P =.027). Conclusions: Adiposity measures all decreased after RYGB but poorly predicted change in cardiometabolic risk. Despite significant reductions at 1 year, a steady regain was observed out to 5 years, with values still well below baseline. Further research should consider control group comparison and extended follow-up.

Original language	English (US)
Pages (from-to)	1154-1161
Number of pages	8
Journal	Surgery for Obesity and Related Diseases
Volume	19
Issue number	10
DOIs	https://doi.org/10.1016/j.soard.2023.04.326
State	Published - Oct 2023

Bibliographical note

Funding Information:
A.J. Beamish has received consulting fees from Johnson & Johnson. A.S. Kelly engages in unpaid consulting and educational activities for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus and Novo Nordisk for National Institute of Diabetes and Digestive and Kidney Diseases–funded clinical trials. D.R. Dengel receives consulting fees from Hologic, Inc. J. Dahlgren has received honoraria as a speaker for Novo Nordisk. C. Marcus is an advisory board member for Itrim; has received research grants from Novo Nordisk and DeFaire Medical, consulting fees from Itrim and Novo Nordisk, and lecture and presentation honoraria from Novo Nordisk; has provided expert testimony for Rhythm; and holds stock in Evira. T. Olbers has received reimbursement to his institution for participation in advisory boards and educational activities from Ethicon/Johnson & Johnson and NovoNordisk. Funding for this study was provided by the Swedish Research Council, Swedish Governmental Agency for Innovation Systems, National Board of Health and Welfare, Swedish Heart and Lung Foundation, Swedish Childhood Diabetes Foundation, Swedish Order of Freemasons Children's Foundation; Stockholm County Council, Västra Götaland Region, Mrs Mary von Sydow Foundation, Stiftelsen Göteborgs Barnhus, and Stiftelsen Allmänna Barnhuset.

Funding Information:
A.J. Beamish has received consulting fees from Johnson & Johnson. A.S. Kelly engages in unpaid consulting and educational activities for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus and Novo Nordisk for National Institute of Diabetes and Digestive and Kidney Diseases–funded clinical trials. D.R. Dengel receives consulting fees from Hologic, Inc. J. Dahlgren has received honoraria as a speaker for Novo Nordisk. C. Marcus is an advisory board member for Itrim; has received research grants from Novo Nordisk and DeFaire Medical, consulting fees from Itrim and Novo Nordisk, and lecture and presentation honoraria from Novo Nordisk; has provided expert testimony for Rhythm; and holds stock in Evira. T. Olbers has received reimbursement to his institution for participation in advisory boards and educational activities from Ethicon/Johnson & Johnson and NovoNordisk. Funding for this study was provided by the Swedish Research Council, Swedish Governmental Agency for Innovation Systems, National Board of Health and Welfare, Swedish Heart and Lung Foundation, Swedish Childhood Diabetes Foundation, Swedish Order of Freemasons Children's Foundation; Stockholm County Council, Västra Götaland Region, Mrs Mary von Sydow Foundation, Stiftelsen Göteborgs Barnhus, and Stiftelsen Allmänna Barnhuset.

Publisher Copyright:
© 2023 American Society for Metabolic and Bariatric Surgery

Keywords

Adiposity
Adolescent
Body composition
Gastric bypass
Metabolic and bariatric surgery

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.soard.2023.04.326

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Beamish, A. J., Dengel, O. H., Palzer, E. F., Gronowitz, E., Kelly, A. S., Dengel, D. R., Rudser, K. D., Brissman, M., Olbers, T., Dahlgren, J., Flodmark, C. E., Marcus, C., & Ryder, J. R. (2023). Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y gastric bypass in adolescents. Surgery for Obesity and Related Diseases, 19(10), 1154-1161. https://doi.org/10.1016/j.soard.2023.04.326

Beamish, AJ, Dengel, OH, Palzer, EF, Gronowitz, E, Kelly, AS , Dengel, DR , Rudser, KD, Brissman, M, Olbers, T, Dahlgren, J, Flodmark, CE, Marcus, C & Ryder, JR 2023, 'Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y gastric bypass in adolescents', Surgery for Obesity and Related Diseases, vol. 19, no. 10, pp. 1154-1161. https://doi.org/10.1016/j.soard.2023.04.326

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title = "Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y gastric bypass in adolescents",

abstract = "Background: Roux-en-Y gastric bypass (RYGB) among adolescents with obesity results in significant weight loss; however, depot-specific changes have been understudied. Objective: We hypothesized that visceral adipose tissue (VAT) reduction in adolescents undergoing RYGB would be greater than other depots and associated with improvement in cardiometabolic risk factors. Setting: Three specialized treatment centers in Sweden. Methods: Fifty-nine adolescents underwent dual x-ray absorptiometry before surgery and at 1, 2, and 5 years after RYGB. Changes in body composition in multiple depots (total fat, lean body, gynoid fat, android fat, subcutaneous adipose tissue, and VAT) and cardiometabolic risk factors were assessed using multiple linear regression analysis and generalized estimating equations adjusting for age, sex, and baseline risk factor levels. Data are presented as percent change (95% CI) with regression models showing slopes and estimated P values. Results: At 1 year post-RYGB, a significant reduction was observed across all body composition measures (P <.001) with the greatest reduction observed in VAT (–65.1% [–68.7, –61.8]). From year 1 to 5 years post-RYGB, a regain was observed in all depots except lean body mass (1.2% [.3, 2.7], P =.105). A sex-specific difference in overall trajectories was only observed in lean body mass with males consistently having higher mean levels. Change in VAT at 1 year correlated with change in triglycerides (slope:.21 mg/dL/kg, P =.034) and fasting plasma insulin (slope: 44 pmol/L/kg, P =.027). Conclusions: Adiposity measures all decreased after RYGB but poorly predicted change in cardiometabolic risk. Despite significant reductions at 1 year, a steady regain was observed out to 5 years, with values still well below baseline. Further research should consider control group comparison and extended follow-up.",

keywords = "Adiposity, Adolescent, Body composition, Gastric bypass, Metabolic and bariatric surgery",

author = "Beamish, {Andrew J.} and Dengel, {Olivia H.} and Palzer, {Elise F.} and Eva Gronowitz and Kelly, {Aaron S.} and Dengel, {Donald R.} and Rudser, {Kyle D.} and Markus Brissman and Torsten Olbers and Jovanna Dahlgren and Flodmark, {Carl Erik} and Claude Marcus and Ryder, {Justin R.}",

note = "Funding Information: A.J. Beamish has received consulting fees from Johnson & Johnson. A.S. Kelly engages in unpaid consulting and educational activities for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus and Novo Nordisk for National Institute of Diabetes and Digestive and Kidney Diseases–funded clinical trials. D.R. Dengel receives consulting fees from Hologic, Inc. J. Dahlgren has received honoraria as a speaker for Novo Nordisk. C. Marcus is an advisory board member for Itrim; has received research grants from Novo Nordisk and DeFaire Medical, consulting fees from Itrim and Novo Nordisk, and lecture and presentation honoraria from Novo Nordisk; has provided expert testimony for Rhythm; and holds stock in Evira. T. Olbers has received reimbursement to his institution for participation in advisory boards and educational activities from Ethicon/Johnson & Johnson and NovoNordisk. Funding for this study was provided by the Swedish Research Council, Swedish Governmental Agency for Innovation Systems, National Board of Health and Welfare, Swedish Heart and Lung Foundation, Swedish Childhood Diabetes Foundation, Swedish Order of Freemasons Children's Foundation; Stockholm County Council, V{\"a}stra G{\"o}taland Region, Mrs Mary von Sydow Foundation, Stiftelsen G{\"o}teborgs Barnhus, and Stiftelsen Allm{\"a}nna Barnhuset. Funding Information: A.J. Beamish has received consulting fees from Johnson & Johnson. A.S. Kelly engages in unpaid consulting and educational activities for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus and Novo Nordisk for National Institute of Diabetes and Digestive and Kidney Diseases–funded clinical trials. D.R. Dengel receives consulting fees from Hologic, Inc. J. Dahlgren has received honoraria as a speaker for Novo Nordisk. C. Marcus is an advisory board member for Itrim; has received research grants from Novo Nordisk and DeFaire Medical, consulting fees from Itrim and Novo Nordisk, and lecture and presentation honoraria from Novo Nordisk; has provided expert testimony for Rhythm; and holds stock in Evira. T. Olbers has received reimbursement to his institution for participation in advisory boards and educational activities from Ethicon/Johnson & Johnson and NovoNordisk. Funding for this study was provided by the Swedish Research Council, Swedish Governmental Agency for Innovation Systems, National Board of Health and Welfare, Swedish Heart and Lung Foundation, Swedish Childhood Diabetes Foundation, Swedish Order of Freemasons Children's Foundation; Stockholm County Council, V{\"a}stra G{\"o}taland Region, Mrs Mary von Sydow Foundation, Stiftelsen G{\"o}teborgs Barnhus, and Stiftelsen Allm{\"a}nna Barnhuset. Publisher Copyright: {\textcopyright} 2023 American Society for Metabolic and Bariatric Surgery",

year = "2023",

month = oct,

doi = "10.1016/j.soard.2023.04.326",

language = "English (US)",

volume = "19",

pages = "1154--1161",

journal = "Surgery for Obesity and Related Diseases",

issn = "1550-7289",

publisher = "Elsevier Inc.",

number = "10",

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TY - JOUR

T1 - Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y gastric bypass in adolescents

AU - Beamish, Andrew J.

AU - Dengel, Olivia H.

AU - Palzer, Elise F.

AU - Gronowitz, Eva

AU - Kelly, Aaron S.

AU - Dengel, Donald R.

AU - Rudser, Kyle D.

AU - Brissman, Markus

AU - Olbers, Torsten

AU - Dahlgren, Jovanna

AU - Flodmark, Carl Erik

AU - Marcus, Claude

AU - Ryder, Justin R.

N1 - Funding Information: A.J. Beamish has received consulting fees from Johnson & Johnson. A.S. Kelly engages in unpaid consulting and educational activities for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus and Novo Nordisk for National Institute of Diabetes and Digestive and Kidney Diseases–funded clinical trials. D.R. Dengel receives consulting fees from Hologic, Inc. J. Dahlgren has received honoraria as a speaker for Novo Nordisk. C. Marcus is an advisory board member for Itrim; has received research grants from Novo Nordisk and DeFaire Medical, consulting fees from Itrim and Novo Nordisk, and lecture and presentation honoraria from Novo Nordisk; has provided expert testimony for Rhythm; and holds stock in Evira. T. Olbers has received reimbursement to his institution for participation in advisory boards and educational activities from Ethicon/Johnson & Johnson and NovoNordisk. Funding for this study was provided by the Swedish Research Council, Swedish Governmental Agency for Innovation Systems, National Board of Health and Welfare, Swedish Heart and Lung Foundation, Swedish Childhood Diabetes Foundation, Swedish Order of Freemasons Children's Foundation; Stockholm County Council, Västra Götaland Region, Mrs Mary von Sydow Foundation, Stiftelsen Göteborgs Barnhus, and Stiftelsen Allmänna Barnhuset. Funding Information: A.J. Beamish has received consulting fees from Johnson & Johnson. A.S. Kelly engages in unpaid consulting and educational activities for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus and Novo Nordisk for National Institute of Diabetes and Digestive and Kidney Diseases–funded clinical trials. D.R. Dengel receives consulting fees from Hologic, Inc. J. Dahlgren has received honoraria as a speaker for Novo Nordisk. C. Marcus is an advisory board member for Itrim; has received research grants from Novo Nordisk and DeFaire Medical, consulting fees from Itrim and Novo Nordisk, and lecture and presentation honoraria from Novo Nordisk; has provided expert testimony for Rhythm; and holds stock in Evira. T. Olbers has received reimbursement to his institution for participation in advisory boards and educational activities from Ethicon/Johnson & Johnson and NovoNordisk. Funding for this study was provided by the Swedish Research Council, Swedish Governmental Agency for Innovation Systems, National Board of Health and Welfare, Swedish Heart and Lung Foundation, Swedish Childhood Diabetes Foundation, Swedish Order of Freemasons Children's Foundation; Stockholm County Council, Västra Götaland Region, Mrs Mary von Sydow Foundation, Stiftelsen Göteborgs Barnhus, and Stiftelsen Allmänna Barnhuset. Publisher Copyright: © 2023 American Society for Metabolic and Bariatric Surgery

PY - 2023/10

Y1 - 2023/10

N2 - Background: Roux-en-Y gastric bypass (RYGB) among adolescents with obesity results in significant weight loss; however, depot-specific changes have been understudied. Objective: We hypothesized that visceral adipose tissue (VAT) reduction in adolescents undergoing RYGB would be greater than other depots and associated with improvement in cardiometabolic risk factors. Setting: Three specialized treatment centers in Sweden. Methods: Fifty-nine adolescents underwent dual x-ray absorptiometry before surgery and at 1, 2, and 5 years after RYGB. Changes in body composition in multiple depots (total fat, lean body, gynoid fat, android fat, subcutaneous adipose tissue, and VAT) and cardiometabolic risk factors were assessed using multiple linear regression analysis and generalized estimating equations adjusting for age, sex, and baseline risk factor levels. Data are presented as percent change (95% CI) with regression models showing slopes and estimated P values. Results: At 1 year post-RYGB, a significant reduction was observed across all body composition measures (P <.001) with the greatest reduction observed in VAT (–65.1% [–68.7, –61.8]). From year 1 to 5 years post-RYGB, a regain was observed in all depots except lean body mass (1.2% [.3, 2.7], P =.105). A sex-specific difference in overall trajectories was only observed in lean body mass with males consistently having higher mean levels. Change in VAT at 1 year correlated with change in triglycerides (slope:.21 mg/dL/kg, P =.034) and fasting plasma insulin (slope: 44 pmol/L/kg, P =.027). Conclusions: Adiposity measures all decreased after RYGB but poorly predicted change in cardiometabolic risk. Despite significant reductions at 1 year, a steady regain was observed out to 5 years, with values still well below baseline. Further research should consider control group comparison and extended follow-up.

AB - Background: Roux-en-Y gastric bypass (RYGB) among adolescents with obesity results in significant weight loss; however, depot-specific changes have been understudied. Objective: We hypothesized that visceral adipose tissue (VAT) reduction in adolescents undergoing RYGB would be greater than other depots and associated with improvement in cardiometabolic risk factors. Setting: Three specialized treatment centers in Sweden. Methods: Fifty-nine adolescents underwent dual x-ray absorptiometry before surgery and at 1, 2, and 5 years after RYGB. Changes in body composition in multiple depots (total fat, lean body, gynoid fat, android fat, subcutaneous adipose tissue, and VAT) and cardiometabolic risk factors were assessed using multiple linear regression analysis and generalized estimating equations adjusting for age, sex, and baseline risk factor levels. Data are presented as percent change (95% CI) with regression models showing slopes and estimated P values. Results: At 1 year post-RYGB, a significant reduction was observed across all body composition measures (P <.001) with the greatest reduction observed in VAT (–65.1% [–68.7, –61.8]). From year 1 to 5 years post-RYGB, a regain was observed in all depots except lean body mass (1.2% [.3, 2.7], P =.105). A sex-specific difference in overall trajectories was only observed in lean body mass with males consistently having higher mean levels. Change in VAT at 1 year correlated with change in triglycerides (slope:.21 mg/dL/kg, P =.034) and fasting plasma insulin (slope: 44 pmol/L/kg, P =.027). Conclusions: Adiposity measures all decreased after RYGB but poorly predicted change in cardiometabolic risk. Despite significant reductions at 1 year, a steady regain was observed out to 5 years, with values still well below baseline. Further research should consider control group comparison and extended follow-up.

KW - Adiposity

KW - Adolescent

KW - Body composition

KW - Gastric bypass

KW - Metabolic and bariatric surgery

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Changes in adipose tissue distribution and relation to cardiometabolic risk factors after Roux-en-Y gastric bypass in adolescents

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Publisher link

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