| Title |
Gastric bypass simultaneously improves adipose tissue function and insulin-dependent type 2 diabetes mellitus
|
|---|---|
| Published in |
Langenbeck's Archives of Surgery, July 2017
|
| DOI | 10.1007/s00423-017-1601-x |
| Pubmed ID | |
| Authors |
Adrian T. Billeter, Spiros Vittas, Barbara Israel, Katharina M. Scheurlen, Asa Hidmark, Thomas H. Fleming, Stefan Kopf, Markus W. Büchler, Beat P. Müller-Stich |
| Abstract |
The 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/m(2)) 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/m(2) with insulin-dependent T2DM after RYGB surgery which resolves T2DM. Twenty patients with insulin-dependent T2DM and BMI <35 kg/m(2) 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. Insulin-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). RYGB 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. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 48 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 17% |
| Researcher | 8 | 17% |
| Student > Bachelor | 4 | 8% |
| Student > Doctoral Student | 2 | 4% |
| Professor | 2 | 4% |
| Other | 5 | 10% |
| Unknown | 19 | 40% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 19% |
| Biochemistry, Genetics and Molecular Biology | 7 | 15% |
| Agricultural and Biological Sciences | 4 | 8% |
| Nursing and Health Professions | 2 | 4% |
| Linguistics | 1 | 2% |
| Other | 2 | 4% |
| Unknown | 23 | 48% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 August 2017.
All research outputs
#14,633,532
of 24,546,092 outputs
Outputs from Langenbeck's Archives of Surgery
#529
of 1,246 outputs
Outputs of similar age
#164,056
of 316,695 outputs
Outputs of similar age from Langenbeck's Archives of Surgery
#9
of 15 outputs
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We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.