Sarcopenic obesity and associated body composition characteristics in individuals undergoing bariatric sugery: a retrospective study

Abstract

S279 Diabetologia (2023) 66 (Suppl 1):S1-S536 1 3 after bariatric surgery mitigating its positive effects on health status, leading to patient dissatisfaction and requiring the need for revisional surgery, which is associated with higher complication and mortality rates. Preoperative predictors contributing to IWL are not sufficiently studied. Therefore, we tried to identify preoperative predictors for IWL to identify patients at risk for IWL after bariatric surgery and thus to improve outcomes. Materials and methods: In this retrospective analytical study, patients who underwent sleeve gastrectomy (SG) or gastric bypass (GB) at our bariatric centre between March 2003 and December 2020 with complete 1 year follow-up data were included. IWL was defined as percentage excess weight loss (%EWL) less than 50% at 1 year after bariatric surgery. A total of 337 patients were included (83% female, 38% after SG, 62% after GB, BMI=46.4+-7.0 kg/m2, age 41+-11 years, from 17 to 67 years (means+-SD)). Kolmogorov-Smirnov test was used to assess the normality of quantitative data. A t-test was performed for parametric and a Mann-Whitney U test for non-parametric, continuous variables. A chi-squared test was performed for categorical variables. Results: 15% experienced IWL. The mean %EWL after 1 year was 82.1+-21.1% in the sufficient weight loss group and 35.8+-13.5% in the insufficient weight loss group. Predictors for sufficient weight loss were lower weight at baseline (p=0.023), lower BMI at baseline (p=0.02), higher HDL levels at baseline (p=0.025), gastric bypass as performed bariatric procedure (p=0.007) and no intake of ß-blockers (0.021). Age, waist circumference, sex, diabetes, HbA1c, fasting glucose and insulin, HOMA index, the intake of diabetes medication or insulin were no predictors for IWL. Conclusion: 15% of patients undergoing SG or GB experienced IWL defined as %EWL less than 50%. Predictors for sufficient weight loss were lower weight, lower BMI and higher HDL levels at baseline, gastric bypass as performed bariatric procedure and no intake of ß-blockers. Disclosure: V. Parzer: None. 551 Sarcopenic obesity and associated body composition characteristics in individuals undergoing bariatric sugery: a retrospective study Background and aims: Sarcopenia can coexist with obesity, together termed sarcopenic obesity (SO). SO is characterised by concomitant low muscle mass and function and excessive fat accumulation. As different relative indices of body composition are used to define SO, data on the prevalence of SO are divergent. This retrospective study aims to examine the prevalence of SO and its associations with pre-operative body composition characteristics, metabolic profile and weight loss success in bariatric surgery candidates. Materials and methods: Retrospective, cross-sectional study evaluating whole-body and regional body composition (assessed by dual-energy x-ray absorptiometry) and biochemical blood variables in adults (age 42±13 years) planned for bariatric surgery (n=78, 23% male, BMI 41.2±3.2 kg/m 2). SO diagnosis was based on sex-specific cut points for relative expressions of appendicular lean tissue mass (ALM, corrected for total body weight (ALM/w) or height squared (ALM/h 2)), as advocated by the Sarcopenic Obesity Global Leadership Initiative. Body composition variables, metabolic profile and weight loss (expressed as percentage total weight loss following surgery) were compared between ALM tertiles using Kruskal-Wallis and Mann-Whitney U tests.