Gastric bypass simultaneously improves adipose tissue function and insulin-dependent type 2 diabetes mellitus

• Verfasst von: Billeter, Adrian [VerfasserIn]
• Verfasst von: Vittas, Spiros [VerfasserIn]
• Verfasst von: Israel, Barbara [VerfasserIn]
• Verfasst von: Scheurlen, Katharina [VerfasserIn]
• Verfasst von: Hidmark, Asa S. [VerfasserIn]
• Verfasst von: Fleming, Thomas [VerfasserIn]
• Verfasst von: Kopf, Stefan [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Verfasst von: Müller, Beat P. [VerfasserIn]
• Titel: Gastric bypass simultaneously improves adipose tissue function and insulin-dependent type 2 diabetes mellitus
• Verf.angabe: Adrian T. Billeter, Spiros Vittas, Barbara Israel, Katharina M. Scheurlen, Asa Hidmark, Thomas H. Fleming, Stefan Kopf, Markus W. Büchler, Beat P. Müller-Stich
• E-Jahr: 2017
• Jahr: 9 July 2017
• Umfang: 10 S.
• Fussnoten: Gesehen am 25.07.2018
• Titel Quelle: Enthalten in: Langenbeck's archives of surgery
• Ort Quelle: Berlin : Springer, 1948
• Jahr Quelle: 2017
• Band/Heft Quelle: 402(2017), 6, Seite 901-910
• ISSN Quelle: 1435-2451
• DOI: doi:10.1007/s00423-017-1601-x
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1577946979

Abstract

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.