American Diabetes Association
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Caloric restriction and weight loss are primary factors in the early tissue-specific metabolic changes after bariatric surgery

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posted on 2022-06-20, 18:11 authored by Charles Robb Flynn, Robyn A. Tamboli, Joseph Antoun, Reem M. Sidani, Brandon Williams, Matthew D. Spann, Wayne J. English, E. Brian Welch, Sinju Sundaresan, Naji N. Abumrad



To evaluate changes in insulin sensitivity, hormone secretion, and hepatic steatosis immediately after caloric restriction, vertical sleeve gastrectomy (VSG), and Roux-en-Y gastric bypass (RYGB).


Obese subjects were assessed for: 1) insulin sensitivity by hyperinsulinemic-euglycemic clamp with glucose tracer infusion, 2) adipokine concentrations by sampling serum and subcutaneous adipose interstitial fluid, and 3) hepatic fat content by magnetic resonance imaging before and 7-10 days after VSG, RYGB, or supervised caloric restriction.


Each group exhibited an approximately 5% total body weight loss, accompanied by similar improvements in hepatic glucose production and hepatic, skeletal muscle, and adipose tissue insulin sensitivity. Leptin concentrations in plasma and adipose interstitial fluid were equally decreased and reductions in hepatic fat were similar.


The improvements in insulin sensitivity and adipokine secretion observed early after bariatric surgery are replicated by equivalent caloric restriction and weight loss. 


This research was supported by NIH grants DK091748 (to NNA), DK020593 (to the Vanderbilt Diabetes Research and Training Center), UL1 TR000445 and TR002243 (Clinical and Translational Science Award; CTSA Grant), and DK058404 (to the Vanderbilt Digestive Disease Research Center).