Key result
Biliopancreatic diversion with duodenal switch induced a >10% increase in Omentin levels in 59% of patients at 24 hours, while the 18% who experienced a decrease showed elevated cardiovascular risk markers.
Why the study?
Does biliopancreatic diversion with duodenal switch bariatric surgery alter Omentin levels and correlate with cardiovascular risk markers in severely obese adults?
Cohort (n=66)
No
Does biliopancreatic diversion with duodenal switch bariatric surgery alter Omentin levels and correlate with cardiovascular risk markers in severely obese adults?
p-value: p=<0.0001
A decrease in Omentin levels 1 day following bariatric surgery may identify a subgroup of severely obese patients at higher risk for cardiovascular complications, independent of weight loss.
Early Omentin decline after duodenal switch was associated with higher CV markers; hypothesis-generating and should not yet change practice.
BACKGROUND: Although no receptor has yet been identified, changes in circulating levels of the adipokine designated as Omentin have been demonstrated in obesity and related comorbidities such as cardiovascular disease, insulin resistance, metabolic syndrome and chronic inflammation. METHODS: Changes in Omentin levels at 1 and 5 days and 6 and 12 months in response to biliopancreatic diversion with duodenal switch bariatric surgery were evaluated, specifically to investigate if changes preceded gain of insulin sensitivity. RESULTS: Pre-operative plasma Omentin was not different between men (n = 18) vs women (n = 48), or diabetic status but correlated with body mass index (BMI). Altogether, Omentin increased as early as 24-h post-surgery, with changes maintained up to 1-year. Fifty-nine percent of subjects increased Omentin >10% by 24-H following surgery (OmentinINC p < 0.0001), while 18% of subjects decreased (OmentinDEC p < 0.0001), with changes maintained throughout one-year. These two groups had comparable age, sex distribution, diabetes, BMI, waist circumference and fat mass, however OmentinDEC had elevated levels of cardiovascular risk markers; homocysteine (p = 0.019), NT-proBNP (p = 0.006) and total bilirubin (p = 0.0001) while red blood cell (RBC) count was lower (p = 0.0005) over the one-year period. Omentin levels at 1-DAY also correlated with immune parameters (white blood cell count, % neutrophil, % monocytes, % lymphocytes). CONCLUSION: OmentinDEC at 1 day following surgery may be a marker of cardiovascular "at-risk" group before weight loss or insulin sensitivity restoration.
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Lapointe et al. (2014) conducted a cohort in Severe obesity (n=66). Biliopancreatic diversion with duodenal switch (BPD-DS) vs. Pre-operative baseline was evaluated on Change in Omentin levels at 24 hours post-surgery (p=<0.0001). Biliopancreatic diversion with duodenal switch induced a >10% increase in Omentin levels in 59% of patients at 24 hours, while the 18% who experienced a decrease showed elevated cardiovascular risk markers.
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