Lourdes Garrido-Sánchez1, Monica Tomé2, Concepcion Santiago-Fernández2, Sara García-Serrano3, Eduardo García-Fuentes4, Francisco J Tinahones5. 1. Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria/Universidad de Málaga, Malaga, Spain; CIBEROBN, Instituto de Salud Carlos III, Malaga, Spain. Electronic address: lourgarrido@gmail.com. 2. Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria/Universidad de Málaga, Malaga, Spain. 3. Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario, Malaga, Spain; CIBERDEM, Instituto de Salud Carlos III, Malaga, Spain. 4. CIBEROBN, Instituto de Salud Carlos III, Malaga, Spain; Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario, Malaga, Spain. Electronic address: edugf1@gmail.com. 5. Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria/Universidad de Málaga, Malaga, Spain; CIBEROBN, Instituto de Salud Carlos III, Malaga, Spain.
Abstract
BACKGROUND: Bariatric surgery improves glycemic metabolism, even before weight loss. However, this improvement in carbohydrate metabolism is not always sufficient for complete remission of type 2 diabetes (T2D). The previous inflammatory state of the adipose tissue may affect this improvement. OBJECTIVES: We assessed whether the gene expression of inflammatory markers in visceral adipose tissue and subcutaneous adipose tissue (SAT) was associated with the short-term remission of T2D after bariatric surgery. SETTINGS: Virgen de la Victoria Clinical Hospital and Regional University Hospital, both in Malaga, Spain. METHODS: We analyzed the baseline mRNA expression of interleukin 6, tumor necrosis factor α (TNF-α), CD11 B, CD163, CD11 C, fatty acid synthase, B-cell CLL/lymphoma 2, caspase 3 (CASP3), and peroxisome proliferator-related receptor γ in 60 morbidly obese patients with T2D treated before bariatric surgery with metformin, classified according to whether they were still being treated with metformin 3 months after bariatric surgery (MO-T2D+) or not (MO-T2D-). RESULTS: The MO-T2D- group reported higher interleukin 6, TNF-α, and CD11 B and lower CD163 baseline mRNA expression in SAT than the MO-T2D+group. Lower TNF-α, CD11 B, fatty acid synthase, and CASP3 and higher CD11 C mRNA expression was found in SAT than in visceral adipose tissue only in the MO-T2D+group. The baseline variable associated with the presence of T2D 3 months after bariatric surgery in a logistic regression model was the mRNA expression of TNF-α in SAT (B = -290.1, P = .017) (R2 = .338). CONCLUSIONS: This study reports for the first time, to our knowledge, that morbidly obese patients with T2D who still required metformin treatment 3 months after bariatric surgery had a lower level of inflammatory mRNA gene expression in SAT before bariatric surgery.
BACKGROUND: Bariatric surgery improves glycemic metabolism, even before weight loss. However, this improvement in carbohydrate metabolism is not always sufficient for complete remission of type 2 diabetes (T2D). The previous inflammatory state of the adipose tissue may affect this improvement. OBJECTIVES: We assessed whether the gene expression of inflammatory markers in visceral adipose tissue and subcutaneous adipose tissue (SAT) was associated with the short-term remission of T2D after bariatric surgery. SETTINGS: Virgen de la Victoria Clinical Hospital and Regional University Hospital, both in Malaga, Spain. METHODS: We analyzed the baseline mRNA expression of interleukin 6, tumor necrosis factor α (TNF-α), CD11 B, CD163, CD11 C, fatty acid synthase, B-cell CLL/lymphoma 2, caspase 3 (CASP3), and peroxisome proliferator-related receptor γ in 60 morbidly obesepatients with T2D treated before bariatric surgery with metformin, classified according to whether they were still being treated with metformin 3 months after bariatric surgery (MO-T2D+) or not (MO-T2D-). RESULTS: The MO-T2D- group reported higher interleukin 6, TNF-α, and CD11 B and lower CD163 baseline mRNA expression in SAT than the MO-T2D+group. Lower TNF-α, CD11 B, fatty acid synthase, and CASP3 and higher CD11 C mRNA expression was found in SAT than in visceral adipose tissue only in the MO-T2D+group. The baseline variable associated with the presence of T2D 3 months after bariatric surgery in a logistic regression model was the mRNA expression of TNF-α in SAT (B = -290.1, P = .017) (R2 = .338). CONCLUSIONS: This study reports for the first time, to our knowledge, that morbidly obesepatients with T2D who still required metformin treatment 3 months after bariatric surgery had a lower level of inflammatory mRNA gene expression in SAT before bariatric surgery.
Authors: Concepción Santiago-Fernández; Luis M Pérez-Belmonte; Mercedes Millán-Gómez; Inmaculada Moreno-Santos; Fernando Carrasco-Chinchilla; Amalio Ruiz-Salas; Luis Morcillo-Hidalgo; José M Melero; Lourdes Garrido-Sánchez; Manuel Jiménez-Navarro Journal: J Transl Med Date: 2019-03-20 Impact factor: 5.531