The objective of this study was to determine if surgical reduction of intra-abdominal (visceral) adipose tissue through omentectomy improves metabolic abnormalities in obese persons. For that purpose, a randomized controlled trial was conducted to compare the metabolic effects of a specific procedure, Roux-en-Y gastric bypass surgery (RYGB), with (n=11) or without omentectomy (n=11). At the same time, a longitudinal single-arm study was performed to investigate the effect of the removal of omental fat alone on glucose-insulin homeostasis indices in 7 obese subjects with type 2 diabetes. Results from the study with the RYGB procedure showed a 2-fold increase in muscle insulin sensitivity and 4-fold increase in hepatic insulin sensitivity 12 months after the preocedure with and without omentectomy. However, no significant differences were observed between groups. In the second study with omentectomy alone, insulin sensitivity, glucose effectiveness and β-cell function did not change significantly. Thus, these findings suggest that surgical removal of intra-abdominal adipose tissue with or without weight loss did not improve insulin sensitivity or metabolic complications associated with obesity and diabetes.
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