Predictors Identified for Type 2 Diabetes Improvement Following Gastrectomy

A low preoperative visceral fat proportion and low glycated hemoglobin levels are predictors of postoperative improvement in type 2 diabetes among patients who undergo gastrectomy, according to a recent study.

Metabolic surgery is often effective for treating type 2 diabetes, and body mass index (BMI) can be used to indicate whether patients are eligible for surgery. However, BMI does not effectively differentiate between the metabolic risks associated with the same weight of muscle and fat.
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To assess these risks further, the researchers evaluated 52 patients with type 2 diabetes who had a BMI of 35 kg/cm² or more and were undergoing gastrectomy for gastric cancer. Abdominal computed tomography was used to measure preoperative and postoperative visceral fat proportions. The effect of visceral fat proportion on type 2 diabetes was estimated via multivariate logistic regression analysis, and the effectiveness of visceral fat proportion as a predictor of type 2 diabetes improvement was estimated via receiver operating curve analysis.

Results indicated that 33 (63%) patients had demonstrated post-operative improvement in type 2 diabetes. The factors associated with an improvement in type 2 diabetes in the 2 years following gastrectomy were low preoperative visceral fat proportion and low glycated hemoglobin levels. The area under the curve was determined to be 70.2%, which indicated moderate accuracy.

“Preoperative [visceral fat proportion] might be a reasonable predictive factor for type 2 diabetes improvement after gastrectomy for patients with a BMI [at or below 35 kg/cm²],” the researchers concluded. “High-quality studies of visceral fat for metabolic function are needed in the future.”

—Christina Vogt

Reference:

Park MJ, Kim DH, Park BJ, Kim S, Park S, Rosenthal RJ. Impact of preoperative visceral fat proportion on type 2 diabetes in patients with low body mass index after gastrectomy. Surg Obes Related Dis. 2017;13(8):1361-1368. doi:10.1016/j.soard.2017.05.012.