Anny H Xiang1, Mayra P Martinez1, Enrique Trigo2, Kristina M Utzschneider3, Melanie Cree-Green4, Silva A Arslanian5, David A Ehrmann6, Sonia Caprio7, Passant H I H Mohamed8, Darryl H Hwang8, Namir Katkhouda9, Krishna S Nayak10, Thomas A Buchanan2. 1. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA. 2. Division of Endocrinology and Diabetes, Department of Medicine and Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 3. Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System and the University of Washington, Seattle, Washington, USA. 4. Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz, Aurora, Colorado, USA. 5. School of Medicine, UPMC Children's Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 6. Section of Endocrinology, Diabetes and Metabolism, the University of Chicago, Chicago, Illinois, USA. 7. Department of Pediatric/Endocrinology, Yale University School of Medicine, New Haven, Connecticut, USA. 8. Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 9. Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 10. Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA.
Abstract
OBJECTIVE: The aim of this study was to examine the relationship between changes in liver fat and changes in insulin sensitivity and β-cell function 2 years after gastric banding surgery. METHODS: Data included 23 adults with the surgery who had prediabetes or type 2 diabetes for less than 1 year and BMI 30 to 40 kg/m2 at baseline. Body adiposity measures including liver fat content (LFC), insulin sensitivity (M/I), and β-cell responses (acute, steady-state, and arginine-stimulated maximum C-peptide) were assessed at baseline and 2 years after surgery. Regression models were used to assess associations adjusted for age and sex. RESULTS: Two years after surgery, all measures of body adiposity, LFC, fasting and 2-hour glucose, and hemoglobin A1c significantly decreased; M/I significantly increased; and β-cell responses adjusted for M/I did not change significantly. Among adiposity measures, reduction in LFC had the strongest association with M/I increase (r = -0.61, P = 0.003). Among β-cell measures, change in LFC was associated with change in acute C-peptide response to arginine at maximal glycemic potentiation adjusted for M/I (r = 0.66, P = 0.007). Significant reductions in glycemic measures and increase in M/I were observed in individuals with LFC loss >2.5%. CONCLUSIONS: Reduction in LFC after gastric banding surgery appears to be an important factor associated with long-term improvements in insulin sensitivity and glycemic profiles in adults with obesity and prediabetes or early type 2 diabetes.
OBJECTIVE: The aim of this study was to examine the relationship between changes in liver fat and changes in insulin sensitivity and β-cell function 2 years after gastric banding surgery. METHODS: Data included 23 adults with the surgery who had prediabetes or type 2 diabetes for less than 1 year and BMI 30 to 40 kg/m2 at baseline. Body adiposity measures including liver fat content (LFC), insulin sensitivity (M/I), and β-cell responses (acute, steady-state, and arginine-stimulated maximum C-peptide) were assessed at baseline and 2 years after surgery. Regression models were used to assess associations adjusted for age and sex. RESULTS: Two years after surgery, all measures of body adiposity, LFC, fasting and 2-hour glucose, and hemoglobin A1c significantly decreased; M/I significantly increased; and β-cell responses adjusted for M/I did not change significantly. Among adiposity measures, reduction in LFC had the strongest association with M/I increase (r = -0.61, P = 0.003). Among β-cell measures, change in LFC was associated with change in acute C-peptide response to arginine at maximal glycemic potentiation adjusted for M/I (r = 0.66, P = 0.007). Significant reductions in glycemic measures and increase in M/I were observed in individuals with LFC loss >2.5%. CONCLUSIONS: Reduction in LFC after gastric banding surgery appears to be an important factor associated with long-term improvements in insulin sensitivity and glycemic profiles in adults with obesity and prediabetes or early type 2 diabetes.
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