Cognitive Impairment, Insulin Resistance
Conditions
Brief summary
The investigators hypothesize that the improvements in insulin sensitivity, beta (β)-cell function, and inflammation will be greater, and the improvement in sarcopenic obesity will be less, in younger versus older individuals after substantial weight loss induced by sleeve gastrectomy bariatric surgery.
Detailed description
With an aging population that is increasingly susceptible to obesity and obesity-related comorbidities including sarcopenia and diabetes, effective and safe treatment options tailored to the needs of older adults are imperative. While medication and lifestyle interventions generally fail to achieve sustained large-scale weight loss, bariatric surgery is the most effective long-term weight loss treatment for obese patients and improves many of the medical complications associated with obesity. Sleeve gastrectomy (SG) results in substantial weight loss and may be more appropriate for older adults due to its low rate of complications and mortality. Therefore, SG has been proposed as a reasonable primary treatment modality in older obese individuals, with a substantial recent increase in the number of interventions performed. Despite the potential benefits, very little is known of the physiologic and metabolic effects of bariatric surgery, including SG, on glucose homeostasis and muscle physiology in older adults. A fundamental understanding of the effects of excess adiposity and weight loss interventions is of profound importance, especially with emerging evidence that earlier treatment of obesity may delay/prevent many comorbidities. An underlying inflammatory state has been implicated in the pathogenesis of sarcopenia and insulin resistance and may provide an important connection to the age-related declines seen in older obese patients. Therefore, this study aims to evaluate the modifying effect of age and inflammation on the SG-induced changes in body composition, muscle physiology, and insulin sensitivity. This protocol will be conducted in two age cohorts (greater than 60 and less than 50 years old).
Interventions
PROCEDURESleeve gastrectomy
Type of bariatric surgery
Sponsors
Ohio State University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
21 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 21-80 yrs old * BMI ≥ 35 kg/m2 * Undergoing laparoscopic sleeve gastrectomy (SG)
Exclusion criteria
* Smokers * Presence of diabetes mellitus * Taking any medication that might affect metabolism * Severe organ dysfunction * Pregnant or breastfeeding * Prior gastrointestinal surgery that might affect study results * Unable or unwilling to follow the study protocol or any reason the research team believes the subject is not an appropriate candidate for this study * Weight \>450 pounds (Will be unable to fit on the DXA scanner)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Insulin Sensitivity | Change from baseline in Insulin sensitivity at 15% weight loss (up to 4 months after surgery) | Subjects will undergo a clamp procedure to assess insulin sensitivity at baseline and 15% weight loss after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Beta cell function | Change from baseline to 15% weight loss (up to 4 months after surgery) | Subjects will undergo a mixed meal tolerance test at baseline and 15% weight loss |
Countries
United States
Outcome results
None listed