Background: The use of bariatric surgery to treat diabetes mellitus (DM) requires procedures developed for morbid obese in patients with normal and over-weight. Therefore, we started tailoring one anastomosis gastric bypass (BAGUA) adapted to each patient. This study analyzes changes in body composition (BC) of patients with BMI 23-50 after BAGUA as well as influence of DM and MS.
Methods: We studied 79 (37 diabetic and 42 non-diabetic) patients (BMI 23-50) who completed all evaluation appointment (preoperative, 10 days, 1, 3, 6, and 12 months) after tailored BAGUA for obesity, diabetes, or diabesity. Patients were classified according to BMI (23-29, 30-34, 35-50) and bearing or not diabetes. Variables are components of BC as well as DM and MS.
Results: Preoperatively, mean values of weight varied 37 kg (78-115 kg), muscle mass (MM) 8 kg (54-62 kg), while fat mass (FM) 30 kg (22-53 kg). Basal metabolism (BM) was higher in diabetic. After surgery, percentage (%) of excess weight loss (%EWL) ranged from 76 % (BMI 35-50) to 128 % (BMI 23-29), FM 56 % (BMI 23-29) to 65 % (BMI 35-50), without differences bearing DM. MM 12 % (non-diabetics BMI 30-34) to 17 % (diabetics BMI 35-50) and visceral fat (VF) 50 % (diabetics BMI 30-34) to 56 % (non-diabetics BMI 35-50).
Conclusions: After tailored BAGUA, MM maintains steady while FM is highly reduced and variable. BM is reduced in all groups. Diabetics lose less weight and VF but more MM than non-diabetic patients. Preoperative presence of MS influences the changes in BC.