The Changes Of Anthropometric Indexes And Correlation With Insulin Resistance In T2DM Patients After Gastric Bypass

ObjectiveThe aim is to study the changes of anthropometric indexes and correlationwith insulin resistance in type2diabetes mellitus patients after gastric bypass.MethodsWe used the method of retrospective analysis to study42T2DM patientswith BMI28～35kg/m2after the laparoscopic gastric bypass in the Departmentof General Surgery in General Hospital of Armed Police Forces. Testing oralglucose tolerance test, insulin release test and HbA1c blood by a nurse andsent to laboratory;To measure height,weight,waist circumstance(WC) and hipcircumstance by special nurse, then fat content were gotten by body fat meterpreoperatively and then at6months postoperatively. Then calculate the BMI,waist-to-hip ratio (WHR), homeostasis model insulin resistance index(HOMA-IR), insulin sensitivity index (ISI) and insulin action index (IAI).Thestatistical analyzed by SPSS16.0statistical software, general materialdescriptive statistics: mean±standard deviation (plus or minus s);Preoperativeand postoperative comparison using repeated measures analysis ofvariance,the relationship between two variables using pearson correlationanalysis.P values were less than0.05for differences with a statisticalsignificance. ResultsAfter6months of gastric bypass, the remission rate of diabetes was78%（32/41）. Insulin resistance index decreased from6.52preoperatively to2.64after6months’ surgery (P<0.05). Weight and body fat content were significantlydecreased (P <0.05). Each part of the body fat rate was significantly decreased(P <0.05). The reduction of trunk fat (17%) was more than the rest part of thebody. Preoperative insulin resistance index was significantly correlated withtrunk fat (r=0.48, P<0.05). Postoperative insulin resistance was positivecorrelated with weight, body mass index, waist circumference, hipcircumference and body fat（P values were0.006,0.009,0.043,0.030,0.000）.Insulin affect index was negative correlated with body weight, body mass index,hip, hip drop value and body fat (P values were0.045,0.024,0.030,0.021,0.003).ConclusionsAfter laparoscopic gastric bypass, the anthropometric indexes have beenchanged compared with before, the changes of trunk fat content was the biggestin T2DM patients; the changes of anthropometric indexes especially inabdomen in T2DM patients are associated with insulin resistance improvement.