Gastric bypass simultaneously improves adipose tissue function and insulin-dependent type 2 diabetes mellitus
ObjectiveThe underlying causes of type 2 diabetes (T2DM) remain poorly understood. Adipose tissue dysfunction with high leptin, inflammation, and increased oxidative stress may play a pivotal role in T2DM development in obese patients. Little is known about the changes in the adipose tissue after Ro...
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| Hauptverfasser: | , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
9 July 2017
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| In: |
Langenbeck's archives of surgery
Year: 2017, Jahrgang: 402, Heft: 6, Pages: 901-910 |
| ISSN: | 1435-2451 |
| DOI: | 10.1007/s00423-017-1601-x |
| Online-Zugang: | Verlag, Volltext: http://dx.doi.org/10.1007/s00423-017-1601-x Verlag, Volltext: https://link.springer.com/article/10.1007/s00423-017-1601-x 
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| Verfasserangaben: | Adrian T. Billeter, Spiros Vittas, Barbara Israel, Katharina M. Scheurlen, Asa Hidmark, Thomas H. Fleming, Stefan Kopf, Markus W. Büchler, Beat P. Müller-Stich |
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| 245 | 1 | 0 | |a Gastric bypass simultaneously improves adipose tissue function and insulin-dependent type 2 diabetes mellitus |c Adrian T. Billeter, Spiros Vittas, Barbara Israel, Katharina M. Scheurlen, Asa Hidmark, Thomas H. Fleming, Stefan Kopf, Markus W. Büchler, Beat P. Müller-Stich |
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| 520 | |a ObjectiveThe underlying causes of type 2 diabetes (T2DM) remain poorly understood. Adipose tissue dysfunction with high leptin, inflammation, and increased oxidative stress may play a pivotal role in T2DM development in obese patients. Little is known about the changes in the adipose tissue after Roux-Y gastric bypass (RYGB) in non-severely obese patients (BMI < 35 kg/m2) and since these patients have more T2DM-associated complications than obese patients (“obesity paradox”), we investigated changes in adipose tissue function in a cohort of BMI <35 kg/m2 with insulin-dependent T2DM after RYGB surgery which resolves T2DM.MethodsTwenty patients with insulin-dependent T2DM and BMI <35 kg/m2 underwent RYGB. Insulin-resistance, leptin, oxidative stress, and cytokines were determined over 24 months. Expression of cytokines and NF-kappaB pathway genes were measured in leukocytes (PBMC). Adipose tissue inflammation was examined histologically preoperatively and 24 months after RGYB in subcutaneous adipose tissue.ResultsInsulin-resistance, leptin, oxidative stress as well as adipose tissue inflammation decreased significantly after RYGB. Similarly, systemic inflammation was reduced and peripheral blood mononuclear cells (PBMCs) were reprogrammed towards an M2-type inflammation. Loss of BMI correlated with leptin levels (r = 0.891, p < 0.0001), insulin resistance (r = 0.527, p = 0.003), and oxidative stress (r = 0.592, p = 0.016). Leptin correlated with improved insulin resistance (r = 0.449, p = 0.032) while reduced leptin showed a strong association with improved oxidative stress (r = 0.809, p = 0.001). Lastly, reduced oxidative stress correlated strongly with improved insulin-resistance (r = 0.776, p = 0.001).ConclusionsRYGB improves adipose tissue function and inflammation. Leptin as marker for adipose tissue dysfunction may be the mediating factor between insulin resistance and oxidative stress and thereby likely improving T2DM. | ||
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