Planned secondary wound closure at the circular stapler insertion site after laparoscopic gastric bypass reduces postoperative morbidity, costs, and hospital stay
OBJECTIVE We recently reported sex-specific percent body fat (%BF) thresholds (males=23%, females=38%) above which, visceral adipose tissue (VAT) significantly increases. Using monozygotic (MZ) and dizygotic (DZ) twins, we examined the influence of genetics on regional fat distribution measured by dual-energy X-ray absorptiometry, above and below these sex-specific thresholds for VAT accumulation. METHODS Fifty-eight twin pairs (44 MZ, 14 DZ) were recruited from the University of Washington Twin Registry. Segmented linear regression was used to assess the threshold between VAT mass and %BF by sex and by zygosity. To assess the effect of genetics on VAT accumulation, Dunnett's T3 compared MZ and DZ pairs whether the twin pairs were both above the adiposity threshold or not. RESULTS %BF thresholds for VAT accumulation were identified (%BF: M=20.6%, F=39.4%). Zygosity-specific thresholds were not significantly different (p>0.05). If at least one twin was below threshold, DZ twins still exhibited greater within-pair differences than MZ pairs in %BF (p=0.023) but not VAT (p=0.121). CONCLUSIONS Using a twin study approach, we observed no difference by zygosity for the threshold as which VAT accumulates. Additionally, for the first time we observed that while total BF is influenced by genetics, VAT accumulation may depend more on whether a person's %BF is above their sex-specific adiposity threshold. These results suggest that there may not be a genetic predisposition for VAT accumulation but rather it is a result of a predisposition for total fat accumulation.