Key result
Women in the highest tertile of visceral adipose tissue mass were 5 times more likely to have reduced glomerular filtration rate compared to those in the lowest tertile (OR 5.2), while renal function significantly improved 6 months after bariatric surgery across all filtration classes.
Why the study?
Renal dysfunction is a recognized complication of obesity with incompletely characterized pathophysiology, and the gender-specific influence of body composition on renal function and its variations after metabolic and bariatric surgery remains understudied.
Does laparoscopic sleeve gastrectomy improve estimated glomerular filtration rate and how does it correlate with body composition changes in males and females with obesity?
Cohort (n=196)
No
Does laparoscopic sleeve gastrectomy improve estimated glomerular filtration rate and how does it correlate with body composition changes in males and females with obesity?
Odds Ratio: 5.2 (95% CI 1.29–20.99)
p-value: p=0.02
Metabolic and bariatric surgery improves renal function at 6 months, with the improvement correlating with visceral adipose tissue loss in females and excess weight loss in males.
Hypothesis-generating for sex-specific renal benefits after bariatric surgery; prospective trials needed before clinical adoption.
Introduction: Renal dysfunction is a recognized complication of obesity with an incompletely characterized pathophysiology. Improvement of glomerular filtration rate (GFR) after metabolic and bariatric surgery (MBS) has been reported across all classes of renal function. Inter-gender differences with regard to correlates of renal function have been described, but the influence of body composition is an understudied area. We aimed to explore determinants of renal function in obesity and to assess its variations after MBS, with a focus on body composition parameters in males and females, respectively. Materials methods: We conducted a retrospective study on 196 patients who underwent laparoscopic sleeve gastrectomy, evaluated preoperatively and 6 months after the intervention. Recorded data included clinical and biochemical assessment, as well as body composition estimation via dual-energy X-ray absorptiometry. Serum creatinine-based formulas were used for the estimation of GFR. Results: and 6 months excess weight loss (EWL) reached 71.43 ± 17.18%, in females, estimated GFR correlated negatively with visceral adipose tissue (VAT) mass (rho=-.368) and this correlation was stronger in females with type 2 diabetes mellitus. Moreover, women in the third VAT mass tertile were 5 times more likely to have reduced GFR compared to the first tertile. Renal function improved after MBS across all classes of filtration. In males, this improvement correlated with EWL (rho=.358) and lean mass variation (rho=-.412), while in females it correlated with VAT mass variation (rho=-.266). Conclusions: Our results are consistent with previous findings on the positive impact of MBS on renal function and suggest a more prominent impact of visceral adiposity on GFR in females.
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Popa et al. (2024) conducted a cohort in Severe obesity (n=196). High visceral adipose tissue (VAT) mass (third tertile) vs. Low VAT mass (first tertile) was evaluated on Reduced estimated glomerular filtration rate (<90 ml/min/1.73m2) (OR 5.2, 95% CI 1.29-20.99, p=0.02). Women in the highest tertile of visceral adipose tissue mass were 5 times more likely to have reduced glomerular filtration rate compared to those in the lowest tertile (OR 5.2), while renal function significantly improved 6 months after bariatric surgery across all filtration classes.
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