Changes in Glucose Control and Lipid Levels Following Trunk-Based Body Contouring Surgery in Postbariatric and Nonbariatric Patients

Abstract

Background Despite consistent interest over the past 2 decades regarding the metabolic effects of body contouring (BC), previous studies are limited by short follow-up periods, small sample sizes, gender-specific cohorts, and assessment of all anatomic regions together. Objectives This study evaluates the changes in glucose and lipid levels over long-term follow-up after trunk-based BC and compares postbariatric with non-bariatric patients. Methods The retrospective cohort study included patients who underwent trunk-based BC from January 1, 2009 through July 31, 2020 at West Virginia University. A minimum 12-month follow-up was required for inclusion. With BC surgery as the reference point, patients’ glucose, hemoglobin A1c, and lipid levels were assessed prior to surgery and at long-term follow-up. Change over time was compared between postbariatric and non-bariatric cohorts. Multivariable linear regression models were performed to assess the effect of potential confounding variables on the difference between cohorts. Results Seventy-seven BC patients had glucose levels evaluated during the study period, and 36 had lipid profiles obtained. Average follow-up from date of BC was 41.2 months for the patients with glucose follow-up and 40.9 months for those with lipid levels. From pre-BC to endpoint follow-up, glucose levels mildly increased in all patients. Multivariable linear regression models accounting for age showed non-bariatric patients experience significantly improved total cholesterol levels compared to postbariatric patients (p = 0.0320). Weight loss maintained following BC was not associated with significant differences between cohorts. Conclusions Fasting glucose levels marginally increase in most BC patients through follow-up. Non-bariatric patients generally experience more favorable changes in lipid profile following trunk-based BC than do postbariatric patients.

Safety and utility of panniculectomy in renal transplant candidates and end stage renal disease patients

“…20 While panniculectomy may not directly impact the course of such conditions, reduction of overall adipose tissue has been associated with improvements in glycemic and lipid levels. 28 Thirdly, ambulation is associated with faster recovery following major surgery, and rehabilitation programs have been added in efforts of implementing enhanced recovery after surgery protocols. 29 While other risk factors are associated with graft failure, including smoking history, non-adherence to the immunosuppressive regimen, and hypertensive pathologies, obesity often worsens the effects of such factors and, thus, must be properly addressed.…”

“…Secondly, obesity, especially in BMI above 35 kg/m 2 , is largely associated with comorbid conditions that impact graft survival, including diabetes and hypertension 20 . While panniculectomy may not directly impact the course of such conditions, reduction of overall adipose tissue has been associated with improvements in glycemic and lipid levels 28 . Thirdly, ambulation is associated with faster recovery following major surgery, and rehabilitation programs have been added in efforts of implementing enhanced recovery after surgery protocols 29 .…”

Commentary on: Changes in Glucose Control and Lipid Levels Following Trunk-Based Body Contouring Surgery in Postbariatric and Nonbariatric Patients

“…In this article, the authors look at the effects of trunk-based body contouring (BC) surgery on metabolic changes, specifically on glucose and lipid levels, in nonbariatric and bariatric surgery patients. 1 The results of the study can assist with preoperative patient counseling and highlight the need for further study in this area (Video).…”