Clinical and Metabolic Characterization of Long-term Courses of Obesity Patients (AdipFollowup)

Klinische Und Metabolische Charakterisierung Der Langzeitverläufe Von Adipositas-Patienten Mit Vergleich Von Bariatrisch Operierten zu Nicht Operierten Patienten

The long-term courses after bariatric surgery are not sufficiently known. Furthermore there is a heterogeneity in postoperative responses. The aim of this study is to investigate the glycemic course (prediabetes, development of diabetes) of patients with obesity (BMI>=35 kg/m2) who had undergone bariatric surgery compared to patients with obesity who have not. A further aim is to investigate predictors of weight development, development of body composition and insulin sensitivity of patients who had undergone bariatric surgery compared to obesity patients who have not undergone bariatric surgery. The long-term courses after different surgical procedures (Roux-Y vs Sleeve) will be compared. In this study 300 patients with obesity who had been metabolically characterized in a previous study will be recruited. These patients are examined (medical history, physical examination including ECG, BIA, weight, height) and metabolically characterized. Participants without diabetes undergo a glucose tolerance test and fasting blood sampling will be performed in participants with diabetes. All patients complete questionnaires to activity, nutrition, life quality, impulsiveness, depression and eating behavior. Randomly selected participants will be offered an abdominal fat tissue biopsy. When consent is given, this will be performed at least two days after the glucose tolerance test.

Obese patients who have undergone a bariaric surgery as part of routine clinical management within the indication of this intervention.

Obese patients who haveundergone bariatric surgery as part of routine clinical management within the indication of this intervention.

Diabetes mellitus as determined by HbA1c, fasting glucose and/or post-challenge glucose (120 min after an 75g oral glucose tolerance test).

Prediabetes as determined by fasting glucose and/or post-challenge glucose (120 min after an 75g oral glucose tolerance test).

Effect of bariatric surgery versus no surgery on body fat mass assessed by bioelectric impedance analysis.

Effect of bariatric surgery versus no surgery on fat free (kg) mass assessed by bioelectric impedance analysis.

Effect of bariatric surgery versus no surgery on insulin sensitivity assessed by 75g oral glucose tolerance test.

Occurence of manifestations of coronary artery disease (myocardial infarction, angina pectoris) or stroke or peripheral artery disease.

Occurene of depressions as estimate of quality of life assessed by the BDI-II Beck's Depression Inventory (BDI-II) questionnaire (minimum value:0, maximum value: 63; higher score indicate more severe depressive symptoms).

Impulsivity assessed by the Barratt Impulsiveness Scale-15 (BIS-15) questionnaire (minimum value:15, maximum value: 60; higher score indicate higher impulsivity).

Inclusion Criteria: Participation in the study " Das ADIP-Programm: Charakterisierung adipöser Probanden mittels genauer phänotypischer und genotypischer Klassifizierung" Exclusion Criteria: BMI < 35 kg/m2 at start of the previous study Women during pregnancy and lactation Patients who are unable to give their consent Patients who have undergone surgery within the last 3 months acute disease or infection within the last 4 months HIV- or hepatitis B/C-positive for biopsy of fat tissue: known coagulation disorder or PTT or INR out of reference range