Po-Jen Yang1,2,3, Kong-Han Ser4, Ming-Tsan Lin5, Hsiao-Ching Nien6,7, Chiung-Nien Chen8, Wei-Shiung Yang9,10, Wei-Jei Lee11. 1. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. paulpjyang@yahoo.com.tw. 2. Department of Surgery, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan. paulpjyang@yahoo.com.tw. 3. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. paulpjyang@yahoo.com.tw. 4. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan. maxist_ser@hotmail.com. 5. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. linmt@ntu.edu.tw. 6. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. celian0916@yahoo.com.tw. 7. Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan. celian0916@yahoo.com.tw. 8. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. cnchen@ntu.edu.tw. 9. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. wsyang@ntu.edu.tw. 10. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. wsyang@ntu.edu.tw. 11. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan. wjlee_obessurg_tw@yahoo.com.tw.
Abstract
BACKGROUND: Recent studies showed that fetuin-A and matrix metalloproteinase-7 (MMP-7) are type 2 diabetes mellitus (T2DM)-associated markers. Bariatric surgery not only reduces body weight but also improves T2DM. This study aimed to investigate the changes of fetuin-A and MMP-7 in obese subjects with and without T2DM after bariatric surgery. METHODS: We enrolled 130 obese subjects that received bariatric surgery, including 41 Roux-en-Y gastric bypass (RYGB), 67 mini-gastric bypass (MGB), and 22 sleeve gastrectomy (SG) patients. Forty-three patients suffered from T2DM prior to surgery. The fasting serum fetuin-A and MMP-7 levels were measured before and 1 year after surgery. RESULTS: Only five of 43 patients remained diabetic after surgery. Preoperative T2DM patients had higher fetuin-A and MMP-7 levels than non-T2DM subjects. RYGB, MGB, and SG all decreased the fetuin-A levels 1 year after the operation. The MMP-7 levels were not changed after RYGB, MGB, or SG. In multivariate analyses, the preoperative fetuin-A was significantly related to the diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c), while the postoperative fetuin-A was independently related to the waist-to-hip ratio and HbA1c. Moreover, the preoperative MMP-7 level was significantly related to age, DBP, aspartate transaminase, alanine transaminase, and gamma-glutamyl transferase (rGT), while the postoperative MMP-7 level was independently related to age and rGT. CONCLUSIONS: The fetuin-A and MMP-7 levels are both higher in obese T2DM than non-T2DM subjects. The level of fetuin-A is reduced after RYGB, MGB, and SG, but the level of MMP-7 remains unchanged.
BACKGROUND: Recent studies showed that fetuin-A and matrix metalloproteinase-7 (MMP-7) are type 2 diabetes mellitus (T2DM)-associated markers. Bariatric surgery not only reduces body weight but also improves T2DM. This study aimed to investigate the changes of fetuin-A and MMP-7 in obese subjects with and without T2DM after bariatric surgery. METHODS: We enrolled 130 obese subjects that received bariatric surgery, including 41 Roux-en-Y gastric bypass (RYGB), 67 mini-gastric bypass (MGB), and 22 sleeve gastrectomy (SG) patients. Forty-three patients suffered from T2DM prior to surgery. The fasting serum fetuin-A and MMP-7 levels were measured before and 1 year after surgery. RESULTS: Only five of 43 patients remained diabetic after surgery. Preoperative T2DM patients had higher fetuin-A and MMP-7 levels than non-T2DM subjects. RYGB, MGB, and SG all decreased the fetuin-A levels 1 year after the operation. The MMP-7 levels were not changed after RYGB, MGB, or SG. In multivariate analyses, the preoperative fetuin-A was significantly related to the diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c), while the postoperative fetuin-A was independently related to the waist-to-hip ratio and HbA1c. Moreover, the preoperative MMP-7 level was significantly related to age, DBP, aspartate transaminase, alanine transaminase, and gamma-glutamyl transferase (rGT), while the postoperative MMP-7 level was independently related to age and rGT. CONCLUSIONS: The fetuin-A and MMP-7 levels are both higher in obese T2DM than non-T2DM subjects. The level of fetuin-A is reduced after RYGB, MGB, and SG, but the level of MMP-7 remains unchanged.
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