Visceral Obesity Is a Negative Predictor of Remission of Diabetes 1 Year After Bariatric Surgery

Our aim was to identify preoperative anthropometric and clinical parameters that predict the remission of diabetes after Roux-en-Y gastric bypass (RYGB). Fifty severely obese Korean patients with type 2 diabetes underwent RYGB. Visceral and abdominal subcutaneous fat area (SFA) was assessed using computed tomography before and 6 and 12 months after RYGB. Remission was defined as a glycated hemoglobin (A(1C)) level < 6.5% and a fasting glucose concentration < 126 mg/dl for 1 year or more without the use of medication. The visceral-to-SFA ratio decreased from 0.60 +/- 0.30 to 0.53 +/- 0.29 (P = 0.001) after 6 months and decreased further to 0.42 +/- 0.24 (P < 0.001) after 12 months. Thirty-four of the 50 patients (68%) had remission of diabetes (remission group). Compared with patients in the nonremission group, patients in the remission group had a shorter duration of diabetes and lower preoperative A(1C) level, and were less likely to use insulin preoperatively. Preoperative BMI did not differ in two groups. However, the preoperative visceral-to-SFA ratio was greater in the nonremission group compared with the remission group (0.79 +/- 0.29 vs. 0.53 +/- 0.26, P = 0.003). Finally, the preoperative visceral-to-SFA ratio was an independent predictor of the remission of diabetes after RYGB in multiple stepwise logistic regression analysis. In conclusion, our data suggest that visceral adiposity negatively influence the likelihood of the patient experiencing the remission of diabetes after RYGB.