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Omentectomy Not Linked to Better Metabolic Function

Findings suggest increased visceral adipose mass isn't major cause of metabolic dysfunction in obese

FRIDAY, Aug. 6 (HealthDay News) -- In obese patients, surgical removal of the omentum, either alone or along with Roux-en-Y gastric bypass, doesn't improve metabolic function, according to research published in the August issue of Gastroenterology.

Elisa Fabbrini, M.D., of the Washington University School of Medicine in St. Louis, and colleagues analyzed data from two studies. In one study, 22 obese adults were randomized to undergo Roux-en-Y gastric bypass surgery with or without omentectomy, and improvement was measured with the hyperinsulinemic-euglycemic clamp technique. In the other study, seven obese adults with type 2 diabetes underwent laparoscopic omentectomy alone, and improvement was measured with the Frequently Sampled Intravenous Glucose Tolerance Test.

The researchers found that, in the first study, those who did and didn't undergo the omentectomy had similar increases in muscle insulin sensitivity and hepatic insulin sensitivity 12 months after the procedure. In the second study, laparoscopic omentectomy didn't affect patients' insulin sensitivity or use of diabetes medications. The authors concluded that increased visceral adipose mass may not be a major cause of metabolic dysfunction in obese individuals.

"Our results challenge the notion that the small decrease in visceral adipose tissue that occurs with weight loss is an important direct contributor to the observed improvement in insulin sensitivity. These results suggest that increased visceral adipose tissue mass is not an important cause of metabolic dysfunction in obese persons," the authors conclude.

The study was partially funded by Covidien and Ethicon Endo-Surgery.

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