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Improved insulin sensitivity after gastric bypass correlates with decreased total body fat, but not with changes in free fatty acids.

Publication ,  Journal Article
Mor, A; Tabone, L; Omotosho, P; Torquati, A
Published in: Surg Endosc
May 2014

BACKGROUND: Increased plasma free fatty acids (FFAs) are considered one of the key elements in the pathogenesis of insulin resistance (IR) and type 2 diabetes (T2DM). We hypothesize that, in diabetic patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB), a postoperative decrease in FFA will correlate with improved insulin sensitivity (Si). METHODS: A total of 30 obese [body mass index ((BMI) >35 kg/m(2)] patients with a diagnosis of T2DM were studied preoperatively and 12 months after LRYGB in a prospective cohort study. Collected data included intravenous glucose tolerance test (IVGTT), total body composition by dual-energy X-ray absorptiometry and plasma levels of FFA. Si analysis from the IVGTT was estimated from minimal model analysis. Pre- and postoperative variables were compared using a paired sample t test. Relationships between changes in variables were determined with Pearson's correlation test. RESULTS: Twelve months after LRYGB the study population showed a significant decrease in BMI (p = 0.001), FFA (p = 0.03), and total body fat (p = 0.03), with an increase in Si (p = 0.001). Postoperative changes in Si significantly correlated (Pearson's r = -0.53, p = 0.01) with change in total body fat, but not with changes in plasma FFA (Pearson's r = -0.22, p = 0.31). CONCLUSIONS: Our study challenges the notion that IR is mediated to a significant degree by changes in plasma FFA concentration. Instead, changes in adiposity and consequently changes in adipokine release can be the key players in determining remission of T2DM after LRYGB.

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Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

May 2014

Volume

28

Issue

5

Start / End Page

1489 / 1493

Location

Germany

Related Subject Headings

  • Time Factors
  • Surgery
  • Prospective Studies
  • Postoperative Period
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Laparoscopy
  • Insulin Resistance
  • Insulin
 

Citation

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ICMJE
MLA
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Mor, A., Tabone, L., Omotosho, P., & Torquati, A. (2014). Improved insulin sensitivity after gastric bypass correlates with decreased total body fat, but not with changes in free fatty acids. Surg Endosc, 28(5), 1489–1493. https://doi.org/10.1007/s00464-013-3338-0
Mor, Alessandro, Lawrence Tabone, Philip Omotosho, and Alfonso Torquati. “Improved insulin sensitivity after gastric bypass correlates with decreased total body fat, but not with changes in free fatty acids.Surg Endosc 28, no. 5 (May 2014): 1489–93. https://doi.org/10.1007/s00464-013-3338-0.
Mor, Alessandro, et al. “Improved insulin sensitivity after gastric bypass correlates with decreased total body fat, but not with changes in free fatty acids.Surg Endosc, vol. 28, no. 5, May 2014, pp. 1489–93. Pubmed, doi:10.1007/s00464-013-3338-0.
Journal cover image

Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

May 2014

Volume

28

Issue

5

Start / End Page

1489 / 1493

Location

Germany

Related Subject Headings

  • Time Factors
  • Surgery
  • Prospective Studies
  • Postoperative Period
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Laparoscopy
  • Insulin Resistance
  • Insulin