1
|
Bailey CJ, Flatt PR. Duodenal enteroendocrine cells and GIP as treatment targets for obesity and type 2 diabetes. Peptides 2024; 174:171168. [PMID: 38320643 DOI: 10.1016/j.peptides.2024.171168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/08/2024]
Abstract
The duodenum is an important source of endocrine and paracrine signals controlling digestion and nutrient disposition, notably including the main incretin hormone glucose-dependent insulinotropic polypeptide (GIP). Bariatric procedures that prevent nutrients from contact with the duodenal mucosa are particularly effective interventions to reduce body weight and improve glycaemic control in obesity and type 2 diabetes. These procedures take advantage of increased nutrient delivery to more distal regions of the intestine which enhances secretion of the other incretin hormone glucagon-like peptide-1 (GLP-1). Preclinical experiments have shown that either an increase or a decrease in the secretion or action of GIP can decrease body weight and blood glucose in obesity and non-insulin dependent hyperglycaemia, but clinical studies involving administration of GIP have been inconclusive. However, a synthetic dual agonist peptide (tirzepatide) that exerts agonism at receptors for GIP and GLP-1 has produced marked weight-lowering and glucose-lowering effects in people with obesity and type 2 diabetes. This appears to result from chronic biased agonism in which the novel conformation of the peptide triggers enhanced signalling by the GLP-1 receptor through reduced internalisation while reducing signalling by the GIP receptor directly or via functional antagonism through increased internalisation and degradation.
Collapse
Affiliation(s)
| | - Peter R Flatt
- Diabetes Research Centre, School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA Northern Ireland, UK
| |
Collapse
|
2
|
Huh YJ, Lee HJ. Metabolic Surgery in Korea. JOURNAL OF METABOLIC AND BARIATRIC SURGERY 2023; 12:17-25. [PMID: 38196782 PMCID: PMC10771972 DOI: 10.17476/jmbs.2023.12.2.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/28/2023] [Accepted: 10/29/2023] [Indexed: 01/11/2024]
Abstract
Metabolic surgery (MS) is a surgery that focuses on improving obesity-related comorbidities. It is often referred to as "diabetic surgery" because of its focus on treating type 2 diabetes. MS is distinguished from bariatric surgery (BS), in which weight loss is the primary goal. However, from a broader perspective, all surgeries for obese patients with diabetes can be considered MS. In Korea, metabolic and bariatric surgery (MBS) has been covered by the national health insurance since 2019. Patients with a body mass index (BMI) ≥35 or those with a BMI ≥30 and obesity-related comorbidities were eligible for MBS. Simultaneously, MS for patients with BMI values between 27.5 and 30 was partly reimbursed. The two major metabolic surgeries are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). According to the registry of the Korean Society of Metabolic and Bariatric Surgery, 1,560 metabolic surgeries for obese patients with diabetes were performed between 2019 and 2021 in Korea, which was approximately 35.6% of all bariatric surgeries. SG was the most common, followed by RYGB and duodenal switch surgery. When dividing the patients with diabetes who underwent MBS into two groups, specifically those with BMI <35 and ≥35, we found that SG was performed most common procedure in both groups. However, there was a higher proportion of RYGB and duodenal switch operation in the former, indicating a difference in surgical methods between the two groups. MS is a promising tool for the management of poorly controlled diabetes. More data are needed to establish proper patient selection and choice of surgical type.
Collapse
Affiliation(s)
- Yeon-Ju Huh
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
| | - Hyuk-Joon Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
3
|
Hrovatin K, Bastidas-Ponce A, Bakhti M, Zappia L, Büttner M, Salinno C, Sterr M, Böttcher A, Migliorini A, Lickert H, Theis FJ. Delineating mouse β-cell identity during lifetime and in diabetes with a single cell atlas. Nat Metab 2023; 5:1615-1637. [PMID: 37697055 PMCID: PMC10513934 DOI: 10.1038/s42255-023-00876-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 07/26/2023] [Indexed: 09/13/2023]
Abstract
Although multiple pancreatic islet single-cell RNA-sequencing (scRNA-seq) datasets have been generated, a consensus on pancreatic cell states in development, homeostasis and diabetes as well as the value of preclinical animal models is missing. Here, we present an scRNA-seq cross-condition mouse islet atlas (MIA), a curated resource for interactive exploration and computational querying. We integrate over 300,000 cells from nine scRNA-seq datasets consisting of 56 samples, varying in age, sex and diabetes models, including an autoimmune type 1 diabetes model (NOD), a glucotoxicity/lipotoxicity type 2 diabetes model (db/db) and a chemical streptozotocin β-cell ablation model. The β-cell landscape of MIA reveals new cell states during disease progression and cross-publication differences between previously suggested marker genes. We show that β-cells in the streptozotocin model transcriptionally correlate with those in human type 2 diabetes and mouse db/db models, but are less similar to human type 1 diabetes and mouse NOD β-cells. We also report pathways that are shared between β-cells in immature, aged and diabetes models. MIA enables a comprehensive analysis of β-cell responses to different stressors, providing a roadmap for the understanding of β-cell plasticity, compensation and demise.
Collapse
Affiliation(s)
- Karin Hrovatin
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
- TUM School of Life Sciences Weihenstephan, Technical University of Munich, Freising, Germany
| | - Aimée Bastidas-Ponce
- Institute of Diabetes and Regeneration Research, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Medical Faculty, Technical University of Munich, Munich, Germany
| | - Mostafa Bakhti
- Institute of Diabetes and Regeneration Research, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Luke Zappia
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
- Department of Mathematics, Technical University of Munich, Garching, Germany
| | - Maren Büttner
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
- Genomics and Immunoregulation, Life & Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
- Systems Medicine, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn, Germany
| | - Ciro Salinno
- Institute of Diabetes and Regeneration Research, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Medical Faculty, Technical University of Munich, Munich, Germany
| | - Michael Sterr
- Institute of Diabetes and Regeneration Research, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Anika Böttcher
- Institute of Diabetes and Regeneration Research, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Adriana Migliorini
- Institute of Diabetes and Regeneration Research, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- McEwen Stem Cell Institute, University Health Network (UHN), Toronto, Ontario, Canada
| | - Heiko Lickert
- Institute of Diabetes and Regeneration Research, Helmholtz Zentrum München, Neuherberg, Germany.
- German Center for Diabetes Research (DZD), Neuherberg, Germany.
- Medical Faculty, Technical University of Munich, Munich, Germany.
| | - Fabian J Theis
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany.
- TUM School of Life Sciences Weihenstephan, Technical University of Munich, Freising, Germany.
- Department of Mathematics, Technical University of Munich, Garching, Germany.
| |
Collapse
|
4
|
Sharma A, Wu L, Bloom S, Stanga P, Nehemy MB, Misra DK, Berrocal MH, Acaba-Berrocal L, Calvão-Santos G, Sousa K, Rezaei KA. RWC Update: Subretinal Cysticercosis; Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy; Waardenburg Syndrome With Pseudo-Choroidal Melanocytosis. Ophthalmic Surg Lasers Imaging Retina 2023; 54:449-452. [PMID: 37603785 DOI: 10.3928/23258160-20230705-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
|
5
|
Alnajjar LI, Alzaben MA, Alghamdi AA, Alomani M, Abbas MS, Altammami RF, Alabdullatif SA, Rokan AKB, Youssef AM, Alhubaishi AA. The remission rate, metabolic changes, and quality of life assessment among patients with type 2 diabetes post-bariatric surgery in Riyadh, Saudi Arabia: A cross-sectional study. Saudi Med J 2023; 44:694-702. [PMID: 37463701 PMCID: PMC10370379 DOI: 10.15537/smj.2023.44.7.20230080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/14/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES To assess the remission rate, metabolic changes, and quality of life after bariatric surgery among Saudi patients with type 2 diabetes (T2DM). METHODS This cross-sectional study was conducted in 2 main centers in the Riyadh, Saudi Arabia. The study included patients with T2DM who underwent either laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) surgery from 2014 to 2018. The remission rate was defined based on the American Diabetes Association (ADA) and the International Diabetes Federation (IDF) criteria. Quality of life was assessed using the World Health Organization Quality of Life (WHOQOL)-BREF. RESULTS A total of 232 patients were included with a mean age of 44.3 ± 10.3 years. 93.4% of the patients had LSG, while only 6.6% had RYGB surgery. Among patients who underwent either LSG or RYGB surgery, there was a significant improvement in metabolic and glycemic markers compared to the baseline. According to the ADA criteria, 48.5% of the patients had complete remission, while 18.9% had partial remission. Overall, 7% of the patients met the IDF optimization criteria, while 5.7% met the IDF improvement criteria. The mean score for all the QOL domains exceeded 63 ± 13, with the environmental and physical health domains having the highest scores. CONCLUSION Among Saudi patients, bariatric surgery was associated with high remission rates and a better quality of life.
Collapse
Affiliation(s)
- Lina I. Alnajjar
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Mohammed A. Alzaben
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Atheer A. Alghamdi
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Munirah.O. Alomani
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Maha S. Abbas
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Rahaf F. Altammami
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Sara A. Alabdullatif
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Aljawharah K. Bin Rokan
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Amira M. Youssef
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| | - Alaa A. Alhubaishi
- From the Department of Pharmacy Practice (Alnajjar, Alhubaishi), and from the College of Pharmacy (Alnajjar, Alhubaishi, Alghamdi, Alomani, Abbas, Altammami, Alabdullatif, Bin Rokan), Princess Nourah bint Abdulrahman University; from the Medical Affairs, Department (Alzaben);, Sultan Bin Abdulaziz Humanitarian City; and from the Research and Scientific Center (Youssef), Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia.
| |
Collapse
|
6
|
Safety and Efficacy of Laparoscopic Vertical Clip Gastroplasty: Early Results of an Italian Multicenter Study. Obes Surg 2023; 33:303-312. [PMID: 36459357 DOI: 10.1007/s11695-022-06364-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/28/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE Sleeve gastrectomy, the most commonly performed bariatric surgery procedure, carries limitations both short term including postoperative complications such as hemorrhage and gastric fistula and long term such as weight regain and gastroesophageal reflux. A new procedure has been proposed to overcome many of these limitations: laparoscopic vertical clip gastroplasty (LVCG) with BariClip. MATERIALS AND METHODS Fifty patients were offered LVCG and enrolled for a feasibility study in two referral bariatric centers. Indication was given as for sleeve gastrectomy, after a multidisciplinary path evaluating age, gender, BMI, comorbidities, eating behaviors, and gastroesophageal reflux. The primary outcome was major postoperative complications. Secondary outcomes included weight loss, incidence of de-novo GERD, and comorbidity resolution. RESULTS Patients had a mean age of 44 years and mean BMI of 37 kg/m2 ± 6.2. All procedures were performed successfully in laparoscopy, with no conversion or intraoperative adverse events. The overall major postoperative complication rate was 6%. Re-operation was required in three patients for slippage. No mortality occurred. Excess weight loss, excess BMI loss, and total weight loss at 6 months were 36%, 57%, and 22%, respectively. There was no instance of de-novo GERD. Resolution of hypertension occurred in 50% of cases, OSAS in 65% of cases, and DMII in 80% of cases. CONCLUSION The safety of LVCG procedure has been reproduced in a multicentric, multi-surgeon study. Weight loss outcomes appear promising. A randomized trial is needed to fully assess the benefits of LVCG.
Collapse
|
7
|
Liu N, Chen X, Ran J, Yin J, Zhang L, Yang Y, Cen J, Dai H, Zhou J, Gao K, Zhang J, Liu L, Chen Z, Wang H. Investigating the change in gene expression profile of blood mononuclear cells post-laparoscopic sleeve gastrectomy in Chinese obese patients. Front Endocrinol (Lausanne) 2023; 14:1049484. [PMID: 36998473 PMCID: PMC10043499 DOI: 10.3389/fendo.2023.1049484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/27/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (LSG) is a sustainable technique that effectively treats morbid obesity. However, the molecular mechanisms underlying the improvement of metabolic health following this process warrants more investigation. This study investigates LSG-related molecules and uses bulk RNA-sequencing high-throughput analysis to unravel their regulatory mechanisms. METHODS Peripheral blood mononuclear cells (PBMC) were collected from ten obese patients with BMI ≥ 32.5 kg/m2 in the Department of General Surgery of Kunming First People's Hospital. After LSG, patients were followed up for one month, and blood samples were retaken. Blood samples from ten patients before and after LSG and bulk RNA-Seq data were analyzed in this study. LSG-associated gene expression was detected by weighted gene coexpression network analysis (WGCNA) and differential analysis. Subsequently, essential signature genes were identified using logistic least absolute shrinkage and selection operator (LASSO) and support vector machine-recursive feature elimination (SVM-RFE) algorithms. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and single-sample gene set enrichment analysis (ssGSEA) were utilized to reveal the potential functions of the target genes. Furthermore, the Pearson correlation of signature genes with leptin and lipocalin was also explored. Finally, we constructed a robust endogenous RNA (ceRNA) network based on miRWalk and starBase databases. RESULTS We identified 18 overlapping genes from 91 hub genes, and 165 differentially expressed mRNAs (DE-mRNA), which were revealed to be significantly associated with immune cells, immune response, inflammatory response, lipid storage, and localization upon functional enrichment analysis. Three signature genes, IRF1, NFKBIA, and YRDC, were identified from the 18 overlapping genes by LASSO and SVM-REF algorithms. The logistic regression model based on the three signature genes highlighted how robustly they discriminated between samples. ssGSEA indicated these genes to be involved in lipid metabolism and degradation pathways. Moreover, leptin levels were significantly reduced in patients undergoing LSG, and NFKBIA significantly negatively correlated with leptin. Finally, we identified how the long non-coding RNA (lncRNA) ATP2B1-AS1 regulated the expression of the signature genes by competitively binding to six microRNAs (miRNAs), which were hsa-miR-6509-5p, hsa-miR-330-5P, hsa-miR-154-5P, hsa-miR-145-5P, hsa-miR4726-5P and hsa-miR-134-5P. CONCLUSION This study identified three critical regulatory genes significantly differentiated between patients before and after LSG treatment and highlighted their potentially crucial role after bariatric surgery. This provides novel insights to increase our understanding of the underlying mechanisms of weight loss and associated metabolic improvement after bariatric surgery.
Collapse
Affiliation(s)
- Na Liu
- Department of Endocrinology, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Xiaolei Chen
- Department of Endocrinology, The First People’s Hospital of Kunming, Kunming, Yunnan, China
- *Correspondence: Xiaolei Chen,
| | - Jianghua Ran
- Department of Endocrinology, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Jianhui Yin
- Department of General Surgery, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Lijun Zhang
- Department of General Surgery, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Yuelin Yang
- Clinical Laboratory, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Jianchang Cen
- Department of Vascular Surgery, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Hongmei Dai
- Ophthalmology, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Jiali Zhou
- Department of Endocrinology, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Kui Gao
- Department of Endocrinology, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Jihong Zhang
- Department of General Surgery, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Liyin Liu
- Department of General Surgery, The First People’s Hospital of Kunming, Kunming, Yunnan, China
| | - Zhiyuan Chen
- Faculty of Physical Education, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Haibin Wang
- Department of Infectious Diseases, The Affiliated Hospital of YunNan University, Kunming, Yunnan, China
| |
Collapse
|
8
|
Salman AA, Salman MA, Aon MH, Mahdy RE, Abdallah A, Shemy GG, Hassan AM, Amin FAS, Labib S. Impact of Weight Loss on the Severity of Albuminuria in Obese Diabetic Patients Undergoing Laparoscopic Sleeve Gastrectomy and One-Anastomosis Gastric Bypass. Int J Gen Med 2022; 15:6405-6413. [PMID: 35957758 PMCID: PMC9359793 DOI: 10.2147/ijgm.s365113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To examine the effect of weight-loss induced bariatric procedures on albuminuria levels among diabetic patients suffering from obesity. Methods Adults patients who suffer from morbid obesity and type 2 diabetes mellitus (T2DM) were included in a prospective cohort study. Subjects were scheduled to undergo laparoscopic sleeve gastrectomy (LSG) or one-anastomosis gastric bypass (OAGB). The albumin-to-creatinine ratio (ACR) was adopted to assess the degree of albuminuria. Microalbuminuria was determined as a ratio of >2.5-30 mg/mmol and >3.5-30 mg/mmol for males and females, respectively, while macroalbuminuria was diagnosed when the ACR exceeded >30 mg/mmol. Results The mean uACR decreased significantly from 20.95±16.89 to 9.92±12.69mg/mmol in LSG cohort (p <0.001), and from 19.52±16.65 to 9.34±11.77mg/mmol in the OAGB cohort, with no statistically considerable differences between both cohorts at the end of follow-up (p = 0.78). Twelve months after the procedures, the percentages of cases with microalbuminuria decreased significantly to 23.8% and 23.9%, respectively (p < 0.001); likewise, the percentages of cases with macroalbuminuria significantly decreased to 7.9% and 7.5% in the LSG and OAGB groups, respectively (p < 0.001). There were no statistically considerable differences between LSG and OAGB regarding the percentages of patients with micro or macroalbuminuria at the end of follow-up. Besides, there were no significant associations between the degree of weight loss and improvement (p = 0.959) or remission (p = 0.73) of microalbuminuria. Conclusion Bariatric surgery significantly reduced the severity of albuminuria 1-year after the procedure, with no preference for one procedure over the other.
Collapse
Affiliation(s)
| | | | - Mohamed H Aon
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem Ezzat Mahdy
- Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed Abdallah
- General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Gamal Galal Shemy
- General Surgery Department, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt
| | - Ahmed M Hassan
- General Surgery Department, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt
| | | | - Safa Labib
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
9
|
Affiliation(s)
- Clifford J Rosen
- From Tufts University School of Medicine, Boston, and the Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough (C.J.R.)
| | - Julie R Ingelfinger
- From Tufts University School of Medicine, Boston, and the Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough (C.J.R.)
| |
Collapse
|
10
|
Ceriani V, Pinna F, Galantino A, Zakaria AS, Manfrini R, Pontiroli AE, Folli F. Biliopancreatic Diversion (BPD), Long Common Limb Revisional Biliopancreatic Diversion (BPD + LCL-R), Roux-en-Y Gastric Bypass [RYGB] and Sleeve Gastrectomy (SG) mediate differential quantitative changes in body weight and qualitative modifications in body composition: a 5-year study. Acta Diabetol 2022; 59:39-48. [PMID: 34453598 PMCID: PMC8758656 DOI: 10.1007/s00592-021-01777-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/27/2021] [Indexed: 01/01/2023]
Abstract
AIMS Bariatric surgeries induce profound weight loss (decrease in body mass index, BMI), through a decrease in fat mass (FM) and to a much lesser degree of fat-free mass (FFM). Some reports indicate that the weight which is lost after gastric bypass (RYGB) and sleeve gastrectomy (SG) is at least partially regained 2 years after surgery. Here we compare changes in BMI and body composition induced by four bariatric procedures in a 5 years follow-up study. METHODS We analyzed retrospectively modifications in BMI, FM and FFM obtained through Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), biliopancreatic diversion (BPD) and a long common limb revisional biliopancreatic diversion (reduction of the gastric pouch and long common limb; BPD + LCL-R). Patients were evaluated at baseline and yearly for 5 years. Of the whole cohort of 565 patients, a subset of 180 patients had all yearly evaluations, while the remaining had incomplete evaluations. Setting University Hospital. RESULTS In a total of 180 patients evaluated yearly for 5 years, decrease in BMI and FM up to 2 years was more rapid with RYGB and SG than BPD and BPD + LCL-R; with RYGB and SG both BMI and FM slightly increased in the years 3-5. At 5 years, the differences were not significant. When analysing the differences between 2 and 5 years, BPD + LCL-R showed a somewhat greater effect on BMI and FM than RYGB, BPD and SG. Superimposable results were obtained when the whole cohort of 565 patients with incomplete evaluation was considered. CONCLUSIONS All surgeries were highly effective in reducing BMI and fat mass at around 2 years; with RYGB and SG both BMI and FM slightly increased in the years 3-5, while BPD and BPD + LCL-R showed a slight further decreases in the same time interval.
Collapse
Affiliation(s)
| | | | - Antonio Galantino
- Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy
| | - Ahmed S Zakaria
- Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy
| | - Roberto Manfrini
- Endocrinologia E Malattie Metaboliche, Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy
- Unità Dipartimentale Di Diabetologia E Malattie Metaboliche, ASST Santi Paolo E Carlo, Milan, Italy
| | - Antonio E Pontiroli
- Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy.
| | - Franco Folli
- Endocrinologia E Malattie Metaboliche, Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Ospedale San Paolo, Via Antonio di Rudinì 8, 20142, Milan, Italy.
- Unità Dipartimentale Di Diabetologia E Malattie Metaboliche, ASST Santi Paolo E Carlo, Milan, Italy.
| |
Collapse
|
11
|
Howard EJ, Lam TKT, Duca FA. The Gut Microbiome: Connecting Diet, Glucose Homeostasis, and Disease. Annu Rev Med 2021; 73:469-481. [PMID: 34678047 DOI: 10.1146/annurev-med-042220-012821] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Type 2 diabetes rates continue to rise unabated, underscoring the need to better understand the etiology and potential therapeutic options available for this disease. The gut microbiome plays a role in glucose homeostasis, and diabetes is associated with alterations in the gut microbiome. Given that consumption of a Western diet is associated with increased metabolic disease, and that a Western diet alters the gut microbiome, it is plausible that changes in the gut microbiota mediate the dysregulation in glucose homeostasis. In this review, we highlight a few of the most significant mechanisms by which the gut microbiome can influence glucose regulation, including changes in gut permeability, gut-brain signaling, and production of bacteria-derived metabolites like short-chain fatty acids and bile acids. A better understanding of these pathways could lead to the development of novel therapeutics to target the gut microbiome in order to restore glucose homeostasis in metabolic disease. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Elizabeth J Howard
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, Arizona 85721, USA
| | - Tony K T Lam
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario M5G 2C4, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario M5S 1A8, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario M5S 3H2, Canada.,Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario M5G 2C4, Canada
| | - Frank A Duca
- School of Animal and Comparative Biomedical Sciences, University of Arizona, Tucson, Arizona 85721, USA.,BIO5 Institute, University of Arizona, Tucson, Arizona 85721, USA;
| |
Collapse
|