This prospective, single-center observational cohort study aims to explore the relationship between skeletal muscle quality, fat distribution, and metabolic health in Chinese patients with obesity, and to evaluate how bariatric surgery influences these parameters. A total of 120 participants will be enrolled, including 60 patients undergoing bariatric surgery and 60 age- and sex-matched healthy controls. The study involves cross-sectional comparisons of ectopic fat and muscle composition, as well as longitudinal follow-up of surgical patients at multiple time points up to 5 years postoperatively. MRI will be used to quantify regional fat and muscle composition, while metabolic parameters, inflammatory markers, and gut microbiota profiles will also be assessed. Primary outcomes include skeletal muscle mass and fat infiltration, visceral and subcutaneous fat volumes, and changes in insulin resistance. This study seeks to clarify the mechanisms by which bariatric surgery improves metabolic function and to identify early changes in muscle-fat composition that may predict long-term metabolic outcomes.
Study Type
OBSERVATIONAL
Enrollment
120
This is a prospective observational study evaluating the metabolic and tissue-level effects of bariatric surgery in obese individuals. The intervention includes either laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB), performed according to standard clinical guidelines. No experimental procedures are added beyond routine care. Skeletal muscle quality and visceral fat distribution are assessed using MRI and clinical biomarkers at multiple postoperative time points (baseline, 3 months, 12 months, and annually up to 5 years). A healthy control group undergoes baseline evaluation only, without surgical intervention.
Xiangya Third Hospital, Central South University
Changsha, Hunan, China
Change in Skeletal Muscle Fat Infiltration and Quality (measured by MRI)
Quantitative evaluation of intramuscular fat content using MRI-derived proton density fat fraction (PDFF) and muscle attenuation indices in the thigh and paraspinal muscles. Muscle quality will be assessed by MRI signal intensity and texture features to detect early changes in muscle composition post-surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in Visceral and Subcutaneous Fat Volume (measured by MRI)
MRI-based measurement of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), liver fat percentage (LFP), and pancreatic fat percentage (PFP) to track region-specific fat redistribution after bariatric surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in fasting glucose
Fasting glucose to evaluate metabolic improvement after surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in HbA1c
HbA1c to evaluate metabolic improvement after surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in triglycerides
Triglycerides to evaluate metabolic improvement after surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in LDL-C
LDL-C to evaluate metabolic improvement after surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in HDL-C
HDL-C to evaluate metabolic improvement after surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in total cholesterol
total cholesterol to evaluate metabolic improvement after surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in insulin resistance
HOMA-IR to evaluate metabolic improvement after surgery.
Time frame: Baseline, 3 months, 12 months, annually up to 5 years
Change in body mass index
Body mass index (BMI), calculated as weight in kilograms divided by height in meters squared (kg/m²), will be measured at baseline and follow-up visits to assess changes in overall adiposity after bariatric surgery. BMI will be used as a general anthropometric indicator of weight loss efficacy over time.
Time frame: Baseline, 3 months, 12 months annually up to 5 years
Change in waist circumference
Waist circumference will be measured in centimeters using a standardized tape measure at the midpoint between the lowest rib and the iliac crest. This anthropometric indicator will be used to evaluate central (abdominal) fat reduction following bariatric surgery. Measurements will be taken at baseline and at follow-up time points to assess longitudinal changes.
Time frame: Baseline, 3 months, 12 months annually up to 5 years
Change in hip circumference
Hip circumference will be measured in centimeters at the widest portion of the buttocks using a standardized measuring tape. This anthropometric measure will help assess changes in fat distribution following bariatric surgery. Measurements will be recorded at baseline and follow-up visits to monitor longitudinal changes in body composition.
Time frame: Baseline, 3 months, 12 months annually up to 5 years
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