Key result
Roux-en-Y gastric bypass in obese patients with T2DM increased postprandial adiponectin and decreased triglycerides at 90 days, with changes in their AUCs correlating (R=-0.64, P=0.003).
Why the study?
Does Roux-en-Y gastric bypass improve postprandial triglycerides and adiponectin levels in obese patients with type 2 diabetes?
Observational (n=10)
Does Roux-en-Y gastric bypass improve postprandial triglycerides and adiponectin levels in obese patients with type 2 diabetes?
Effect estimate: R=-0.64
p-value: p=0.003
Roux-en-Y gastric bypass reverses postprandial hypertriglyceridemia in obese diabetic patients, potentially mediated by increases in adiponectin levels.
May link post-bypass adiponectin rise to triglyceride reduction in obese T2DM; hypothesis-generating, requires RCTs before practice change.
BACKGROUND: Postprandial hypertrygliceridemia is a known factor for cardiovascular disease and is often observed in patients with type 2 diabetes mellitus (T2DM) and visceral adiposity. Adiponectin is a hormone with antiatherogenic and anti-inflammatory effects, which decreases in obesity and T2DM subjects. The weight loss induced by diet or bariatric surgery could be restoring adiponectin levels. OBJECTIVE: The aim of the study was to evaluate the impact of weight loss induced by bariatric surgery, which could restore adiponectin and triglycerides (TG) levels in obese and diabetic patients. METHODS: Ten patients with T2DM (BMI 39.3+2.44) were evaluated before and at 7 and 90 days after Roux-en-Y gastric bypass (RYGB). A meal test was performed and plasma insulin, glucagon-like peptide-1 (GLP-1), glucose, TG, and adiponectin levels were measured at fasting and at 30, 60, 90, and 120 min postprandial. RESULTS: Seven days after surgery, significant reductions in the insulin resistance were observed, while TG and adiponectin levels remained unchanged during the meal test. Ninety days after surgery, TG and glucose levels decreased significantly at fasting, and postprandial, adiponectin, GLP-1, and insulin curves increased significantly after meal ingestion. Both changes in the area under the curve (AUC) of adiponectin correlated with changes in the AUC of TG (R=-0.64, P=0.003) and changes in AUC of adiponectin correlated with changes in total fat mass. No correlation was found between changes in insulin, GLP-1, and TG levels. CONCLUSIONS: The adiponectin levels may be involved in the mechanism responsible for high TG levels in obese and diabetic patients. These abnormalities can be reversed by RYGB.
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Umeda et al. (2013) conducted an observational in Type 2 diabetes mellitus and obesity (n=10). Roux-en-Y gastric bypass (RYGB) vs. Baseline (before surgery) was evaluated on Correlation between changes in the area under the curve (AUC) of adiponectin and AUC of triglycerides (R=-0.64, p=0.003). Roux-en-Y gastric bypass in obese patients with T2DM increased postprandial adiponectin and decreased triglycerides at 90 days, with changes in their AUCs correlating (R=-0.64, P=0.003).
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