scholarly journals Circulating Levels of Sclerostin Predict Glycemic Improvement after Sleeve Gastrectomy

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 623
Author(s):  
Federico Carbone ◽  
Elisa Nulli Migliola ◽  
Aldo Bonaventura ◽  
Alessandra Vecchié ◽  
Stefano De Vuono ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Insulin Sensitivity ◽  
Metabolic Diseases ◽  
Serum Levels ◽  
Morbidly Obese ◽  
Model Assessment ◽  
Anthropometric Measures ◽  
Baseline Serum ◽  
Peripheral Insulin Sensitivity ◽  
Post Surgery

Among the different effects of bariatric surgery, here we focus on bone-derived inflammatory molecules, and in particular, sclerostin; an osteocyte product potentially associated with cardio-metabolic diseases. In 94 morbidly obese patients undergoing laparoscopic sleeve gastrectomy (SG), over-time changes in anthropometric and biochemical measures—including insulin resistance (IR) indexes—were correlated with serum sclerostin levels. Sclerostin was positively associated with anthropometric indexes of obesity, and inversely with IR, namely homeostatic model assessment for peripheral insulin sensitivity (HOMA2%S) (r = −0.218; p = 0.045). Sclerostin emerged as the only significant predictor of HOMA2-%S normalization, independently of demographic and anthropometric variables (OR 1.01 (95% CI 1.00–1.02); p = 0.024). We also identified two distinct patterns of serum sclerostin change: the higher/lower sclerostin levels at baseline, the greater their post-surgical reduction/increase (p < 0.001 for all subgroups). Among those two patterns, especially the post-surgery increase in serum sclerostin was associated with lean mass reduction, without any association with IR indexes. Although counterintuitive, this change was likely dependent on the post-surgical increase in bone turnover. In conclusion, baseline serum levels of sclerostin correlate with anthropometric measures of obesity and IR, and the ability to predict glycemic improvements after SG. Specifically, serum sclerostin was closely associated with peripheral insulin sensitivity (HOMA2-%S), thus supporting the role of skeletal muscle/bone interactions in metabolic diseases.

scholarly journals Osteoprotegerin in relation to body weight, lipid parameters insulin sensitivity, adipocytokines, and C-reactive protein in obese and non-obese young individuals: results from both cross-sectional and interventional study

2008 ◽  
Vol 158 (3) ◽  
pp. 353-359 ◽  
Author(s):  
Marie-Hélène Gannagé-Yared ◽  
Cesar Yaghi ◽  
Bassem Habre ◽  
Simon Khalife ◽  
Roger Noun ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Density Lipoprotein ◽  
Model Assessment ◽  
Homa Index ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Mean Values ◽  
Reactive Protein ◽  
Post Surgery ◽  
Obese Subjects

ObjectiveWe analyzed the relation of osteoprotegerin (OPG) with insulin sensitivity, lipid profile, serum glutamic pyruvic transaminase (SGPT), adipocytokines, and C-reactive protein (CRP) in obese and non-obese subjects.MethodsIn the study, 170 subjects (106 obese and 64 non-obese, sex ratio female/male=2.03) were included. Thirty-two obese subjects were reevaluated 6 months after the weight loss induced by bariatric surgery.ResultsOPG did not differ between obese and non-obese subjects (respective mean values 5.17 and 4.96 pmol/l) or according to gender, but was positively correlated with age (P<0.0001 for both groups). OPG was statistically higher in 18 obese diabetic subjects compared with non-diabetics (P=0.03). After adjustment for age, no significant correlation was found between OPG and body mass index (BMI), waist, systolic and diastolic blood pressure, cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, leptin, and adiponectin in both the obese and non-obese subjects. However, OPG was positively correlated with homeostasis model assessment (HOMA) index and SGPT levels in obese subjects at baseline (r=0.295, r=0.20, P<0.05) and after adjustment for age (r=0.28, r=0.20, P<0.05). OPG was also significantly correlated with CRP; this correlation persisted after adjustment for age in obese subjects (r=0.30, P<0.01). In a multivariate analysis in the obese group, HOMA index and CRP were independent predictors of OPG while SGPT was not. Six months post-surgery, OPG did not change, despite a significant reduction in glucose, SGPT, cholesterol, triglycerides, CRP, and leptin values (P=0.02, P=0.006, P=0.007, P<0.001, P<0.001, P<0.001 respectively) and a significant increase in adiponectin and HDL values (P<0.001 for both variables).ConclusionOur results show that in obese subjects, OPG is not related to BMI. However, we describe new relationships between OPG and both HOMA index and CRP.

scholarly journals Serum adiponectin levels in adults with Prader-Willi syndrome are independent of anthropometrical parameters and do not change with GH treatment

2004 ◽  
pp. 457-461 ◽  
Author(s):  
C Hoybye ◽  
JM Bruun ◽  
B Richelsen ◽  
A Flyvbjerg ◽  
J Frystyk
Keyword(s):  
Metabolic Syndrome ◽  
Insulin Sensitivity ◽  
Gh Deficiency ◽  
Adult Life ◽  
Serum Adiponectin ◽  
Prader Willi Syndrome ◽  
Model Assessment ◽  
Baseline Serum ◽  
The Metabolic Syndrome ◽  
Total Adiponectin

OBJECTIVE: Obesity and growth hormone (GH) deficiency are common in Prader-Willi syndrome (PWS) and these patients are at risk of metabolic diseases in adult life and of reduced life span. Low adiponectin values are associated with obesity and the metabolic syndrome. We therefore found it of interest to measure adiponectin levels in PWS. PATIENTS AND METHODS: 17 adults, nine men and eight women, 17 to 32 years of age, with a mean body mass index (BMI) of 35+/-3.2 kg/m2 participated. All had clinical PWS. They were randomized to treatment with placebo or GH (Genotropin) for six months, and subsequently all received GH for 12 months. At baseline, serum total adiponectin levels in the PWS patients were compared with 25 lean and 34 obese controls. Body composition and various metabolic parameters, including adiponectin, were studied every six months in the PWS group. RESULTS: Serum adiponectin levels in PWS subjects were significantly lower (P<0.001) compared with lean and significantly higher (P<0.001) compared with obese controls. In PWS patients, no correlation was found between adiponectin and anthropometrical parameters or measures of insulin sensitivity (e.g. fasting insulin and insulin sensitivity as estimated by the homeostasis model assessment), or between adiponectin and IGF binding protein-1 or IGF-I. Adiponectin did not change during GH intervention. CONCLUSION: In this study of adults with PWS serum total adiponectin levels were higher than in controls with simple obesity and were independent of anthropometrical parameters. In accordance with this the metabolic syndrome is not necessarily present in all PWS patients. Correction of GH deficiency had no effect on serum adiponectin levels.

scholarly journals Longitudinal analysis of serum cytokine levels and gut microbial abundance links IL-17/IL-22 with Clostridia and insulin sensitivity in humans

2020 ◽  
Author(s):  
Ada Admin ◽  
Xin Zhou ◽  
Jethro S. Johnson ◽  
Daniel Spakowicz ◽  
Wenyu Zhou ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Gut Microbiome ◽  
Metabolic Diseases ◽  
Human Microbiome ◽  
Human Microbiome Project ◽  
Serum Levels ◽  
Discrete Groups ◽  
Cytokine Levels ◽  
Using Data ◽  
Study Participants

Recent studies using mouse models suggest that interaction between the gut microbiome and IL-17/IL-22 producing cells plays a role in the development of metabolic diseases. We investigated this relationship in humans using data from the prediabetes study of the Integrated Human Microbiome Project (iHMP). Specifically, we addressed the hypothesis that early in the onset of metabolic diseases there is a decline in serum levels of IL-17/IL-22, with concomitant changes in the gut microbiome. Clustering iHMP study participants on the basis of longitudinal IL-17/IL-22 profiles identified discrete groups. Individuals distinguished by low levels of IL-17/IL-22 were linked to established markers of metabolic disease, including insulin sensitivity. These individuals also displayed gut microbiome dysbiosis, characterized by decreased diversity, and IL-17/IL-22-related declines in the phylum <i>Firmicutes,</i> class <i>Clostridia</i>, and<i> </i>order <i>Clostridiales.</i> This ancillary analysis of the iHMP data therefore supports a link between the gut microbiome, IL-17/IL-22 and the onset of metabolic diseases. This raises the possibility for novel, microbiome-related therapeutic targets that may effectively alleviate metabolic diseases in humans as they do in animal models.

Safety and Efficacy of Bariatric Surgery in Patients with Cirrhosis

2018 ◽  
Author(s):  
Hideharu Shimizu ◽  
Tomasz G. Rogula ◽  
Philip R. Schauer
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Metabolic Diseases ◽  
Bariatric Procedure ◽  
Morbidly Obese ◽  
Class A ◽  
Bariatric Patients ◽  
Pugh Class ◽  
Cirrhotic Patients ◽  
Perioperative Risks

Perioperative risks for morbidly obese patients with cirrhosis are significant, and surgeons should consider these risks carefully in deciding on the type of bariatric procedure to be performed. The benefits of bariatric surgery for cirrhotic patients include substantial weight loss, improvements in metabolic diseases, and potential regression of fibrosis, which can also increase their eligibility and candidacy for liver transplantation. There is currently a lack of strong evidence, but the restrictive bariatric procedures are the safest options for carefully selected patients with cirrhosis. Sleeve gastrectomy is likely the best bariatric procedure for obtaining good outcomes without a prohibitive complication rate or mortality for patients with compensated, Child-Pugh class A cirrhosis without portal hypertension. Roux-en-Y gastric bypass is also appropriate for patients who are not suitable for sleeve gastrectomy. Surgeons should be prepared in case they see bariatric patients with cirrhosis diagnosed preoperatively or intraoperatively.

scholarly journals EARLY WEIGHT LOSS OUTCOMES AND GLUCOSE METABOLISM PARAMETERS AFTER BANDED VERSUS NON-BANDED ONE ANASTOMOSIS GASTRIC BYPASS: A PROSPECTIVE RANDOMIZED TRIAL

2019 ◽  
Vol 56 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Everton CAZZO ◽  
Felipe Gilberto VALERINI ◽  
Fábio Henrique Mendonça CHAIM ◽  
Pedro França da Costa SOARES ◽  
Almino Cardoso RAMOS ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Glucose Metabolism ◽  
Randomized Study ◽  
Standard Technique ◽  
One Anastomosis Gastric Bypass ◽  
Morbidly Obese ◽  
Model Assessment ◽  
Post Surgery ◽  
Early Weight Loss

ABSTRACT BACKGROUND: The influence of the placement of a band on the outcomes of one anastomosis gastric bypass (OAGB) has not been appropriately studied yet. OBJECTIVE: To compare early weight loss and glucose metabolism parameters following banded versus non-banded OAGB. METHODS: A prospective randomized study, which evaluated 20 morbidly obese individuals who underwent banded and non-banded OAGB and were followed-up for three months. Weight loss (percentage of excess weight loss - %EWL and percentage of body mass index loss - %BMIL) and glucose metabolism outcomes (glucose, insulin and homeostasis model assessment - HOMA) were compared. RESULTS: The banded group presented a significantly higher %EWL at one month (29.6±5.5% vs 17.2±3.4%; P<0.0001) and two months post-surgery (46±7% vs 34.2±9%; P=0.004544), as well as a significantly higher %BMIL at one month (9.7±1.1% vs 5.8±0.8%; P<0.0001), two months (15±1.4% vs 11.5±2.1; P=0.000248), and three months (18.8±1.8% vs 15.7±3.2%; P=0.016637). At three months, banded OAGB led to significant decreases of insulin (14.4±4.3 vs 7.6±1.9; P=0.00044) and HOMA (3.1±1.1 vs 1.5±0.4; P=0.00044), whereas non-banded OAGB also led to significant decreases of insulin (14.8±7.6 vs 7.8±3.1; P=0.006) and HOMA (3.2±1.9 vs 1.6±0.8; P=0.0041). The percent variation of HOMA did not significantly differ between banded and non-banded OAGB (P=0.62414); overall, the percent variation of HOMA was not correlated with %EWL (P=0.96988) or %BMIL (P=0.82299). CONCLUSION: Banded OAGB led to a higher early weight loss than the standard technique. Banded and non-banded OAGB led to improvements in insulin resistance regardless of weight loss.

scholarly journals Adiponectin may mediate the association between omentin, circulating lipids and insulin sensitivity: results from the KORA F4 study

2015 ◽  
Vol 172 (4) ◽  
pp. 423-432 ◽  
Author(s):  
Christian Herder ◽  
D Margriet Ouwens ◽  
Maren Carstensen ◽  
Bernd Kowall ◽  
Cornelia Huth ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Large Population ◽  
Serum Levels ◽  
Population Based ◽  
Whole Body ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Model Assessment ◽  
Related Factors

ObjectiveReduced circulating omentin levels have been reported in obesity and type 2 diabetes, but data were mostly derived from univariate analyses in small study samples. This study aimed to investigate the relationship between omentin, abnormal glucose tolerance and related metabolic factors in a large population-based cross-sectional study.Design and methodsSerum omentin was measured by ELISA in 1092 participants of the German KORA F4 survey (2006–2008). Associations between omentin serum levels, glucose tolerance (assessed with an oral glucose tolerance test) and diabetes-related factors were estimated using logistic and linear regression models respectively.ResultsSerum levels of omentin were not related to categories of glucose tolerance. However, serum omentin was positively associated with whole-body insulin sensitivity index (ISI (composite)) and HDL cholesterol and showed inverse associations with 2-h post-load glucose, fasting insulin, homeostasis model assessment-estimated insulin resistance, BMI and triglycerides (all P≤0.03 after adjustment for age, sex and lifestyle factors). Further adjustment for BMI and/or serum lipids attenuated the associations with parameters of glucose metabolism, whereas adjustment for serum adiponectin virtually abolished all aforementioned associations. In contrast, adjustment for omentin had no effect on the positive association between adiponectin levels and ISI (composite).ConclusionsThe data from this large population-based cohort show that circulating omentin levels are associated with insulin sensitivity. Our observations further suggest that omentin acts via upregulation of adiponectin, which in turn affects lipid metabolism and thereby also indirectly enhances insulin sensitivity, but mechanistic studies are required to corroborate this hypothesis.

scholarly journals Early Postoperative Outcomes and Medication Cost Savings after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients with Type 2 Diabetes

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Bethany J. Slater ◽  
Nina Bellatorre ◽  
Dan Eisenberg
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Cost Savings ◽  
Diabetes Remission ◽  
Medication Cost ◽  
Morbidly Obese ◽  
Model Assessment ◽  
Obese Patients

Background. We investigated the effect of laparoscopic sleeve gastrectomy (LSG) on morbidly obese diabetics and examined the short-term impact of LSG on diabetic medication cost.Methods. A prospective database of consecutive bariatric patients was reviewed. Morbidly obese patients with type 2 diabetes who underwent LSG were included in the study. Age, gender, body mass index (BMI), diabetic medication use, glucose, insulin, and HbA1c levels were documented preoperatively, and at 2 weeks, 2 months, 6 months, and 12 months postoperatively. Insulin resistance was estimated using the homeostatic model assessment (HOMA). Use and cost of diabetic medications were followed.Results. Of 178 patients, 22 were diabetics who underwent LSG. Diabetes remission was observed in 62% of patients within 2 months and in 75% of patients within 12 months. HOMA-IR improved after only two weeks following surgery (16.5 versus 6.6, ). Average number of diabetic medications decreased from 2.2 to <1, within 2 weeks after surgery; corresponding to a diabetes medication cost savings of 80%, 91%, 99%, and 99.7% after 2 weeks, 2 months, 6 months, and 12 months, respectively.Conclusion. Morbidly obese patients with diabetes who undergo LSG have high rates of diabetes remission early after surgery. This translates to a significant medication cost savings.

scholarly journals Effects of sleeve gastrectomy on insulin resistance

2016 ◽  
Vol 89 (2) ◽  
pp. 267-272 ◽  
Author(s):  
Adriana Florinela Cătoi ◽  
Alina Pârvu ◽  
Aurel Mironiuc ◽  
Romeo Florin Galea ◽  
Adriana Mureşan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Plasma Glucose ◽  
Fasting Blood Glucose ◽  
Morbidly Obese ◽  
Model Assessment ◽  
Mean Values ◽  
Significant Change ◽  
Change In Mean

Background and aim. Obesity is a major risk factor for the onset of insulin resistance (IR), hyperinsulinemia and type 2 diabetes mellitus (T2DM) Evidence data has proven that beyond important weight loss bariatric surgery especially Roux-en-Y gastric bypass (RYGB) and bilio-pancreatic diversion (BPD) leads to significant early reduction of insulinemia and of IR calculated through the homeostatic model assessment (HOMA-IR), independently of fat mass decrease. Sleeve gastrectomy (SG) is now used as a sole weight loss operation with good results. Therefore, the aim of the present study was to investigate the early changes of fasting blood glucose, insulin and HOMA-IR in a group of morbidly obese (MO) patients i.e. at 7, 30 and 90 days after SG. Methods. The study included 20 MO patients (7 male and 13 female) submitted to SG. Anthropometrical (weight, body mass index –BMI, percent excess BMI loss -%EBMIL) and biochemical (plasma glucose, insulin and calculated HOMA-IR ) evaluation were performed before and at 7, 30 and 90 days after SG. In addition, a second group of 10 normal weight healthy subjects with a BMI ranging form 19 kg/m² to 23.14 kg/m², matched for age and gender was investigated. Results. Plasma glucose (p=0.018), insulin (p=0.004) and HOMA-IR (p=0.006) values were statistically different between the studied groups. After surgery, at every follow-up point, there were statistically different weight and BMI mean values relative to the operation day (p<0.003). BMI, decreased at 7 days (estimated reduction=2.79; 95% CI:[2.12;3.45]), at 30 days (estimated reduction=5.65; 95% CI:[3.57;7.73]) and at 90 days (estimated reduction=10.88; 95% CI:[7.35;14.41]) respectively after SG. We noted a tendency toward statistical significant change of mean insulin values at 7 days after surgery (corrected p=0.075), no statistical change at 30 days (corrected p=0.327) and a significant change at 90 days (corrected p=0.027) after SG as compared to baseline. There was a significant change in mean values of HOMA-IR at 30 days (corrected p=0.009) and at 90 days (corrected p=0.021) after the operation day. Conclusions. The present study showed important early changes consisting in reductions of mean values of plasma insulin and HOMA-IR after SG.

scholarly journals Longitudinal analysis of serum cytokine levels and gut microbial abundance links IL-17/IL-22 with Clostridia and insulin sensitivity in humans

2020 ◽  
Author(s):  
Ada Admin ◽  
Xin Zhou ◽  
Jethro S. Johnson ◽  
Daniel Spakowicz ◽  
Wenyu Zhou ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Gut Microbiome ◽  
Metabolic Diseases ◽  
Human Microbiome ◽  
Human Microbiome Project ◽  
Serum Levels ◽  
Discrete Groups ◽  
Cytokine Levels ◽  
Using Data ◽  
Study Participants

Recent studies using mouse models suggest that interaction between the gut microbiome and IL-17/IL-22 producing cells plays a role in the development of metabolic diseases. We investigated this relationship in humans using data from the prediabetes study of the Integrated Human Microbiome Project (iHMP). Specifically, we addressed the hypothesis that early in the onset of metabolic diseases there is a decline in serum levels of IL-17/IL-22, with concomitant changes in the gut microbiome. Clustering iHMP study participants on the basis of longitudinal IL-17/IL-22 profiles identified discrete groups. Individuals distinguished by low levels of IL-17/IL-22 were linked to established markers of metabolic disease, including insulin sensitivity. These individuals also displayed gut microbiome dysbiosis, characterized by decreased diversity, and IL-17/IL-22-related declines in the phylum <i>Firmicutes,</i> class <i>Clostridia</i>, and<i> </i>order <i>Clostridiales.</i> This ancillary analysis of the iHMP data therefore supports a link between the gut microbiome, IL-17/IL-22 and the onset of metabolic diseases. This raises the possibility for novel, microbiome-related therapeutic targets that may effectively alleviate metabolic diseases in humans as they do in animal models.

Combining Various Methods to Assess Insulin Sensitivity in Nonobese Rat after Sleeve Gastrectomy

2018 ◽  
Vol 127 (07) ◽  
pp. 477-484
Author(s):  
Dong Sun ◽  
Yanmin Wang ◽  
Meng Wei ◽  
Zongli Zhang ◽  
Sanyuan Hu
Keyword(s):  
Insulin Resistance ◽  
Sleeve Gastrectomy ◽  
Steady State ◽  
Insulin Sensitivity ◽  
Challenge Test ◽  
Resistance Index ◽  
Control Groups ◽  
Hepatic Insulin Sensitivity ◽  
Peripheral Insulin Sensitivity ◽  
And Control

Abstract Background Sleeve gastrectomy (SG) procedure has been proved to improve insulin sensitivity and sustain anti-diabetic effects. Our aim is to co-use several methods to measure insulin sensitivity and investigate the effect of SG on hepatic and peripheral insulin sensitivity at early and long-term stages of postoperation. Methods Thirty 11-week-old male Goto-Kakizaki rats were divided into SG, sham-operated SG (SOSG), and control groups. They were observed before operation and for 36 weeks of postoperation. Insulin tolerance test (ITT) and homeostasis model of assessment for insulin resistance index(HOMA-IR)were used to measure insulin resistance before operations and at 2 and 36 weeks of postoperation; Pyruvate challenge test (PCT) was administrated to assess the gluconeogenesis capability in order to reflect hepatic insulin sensitivity before operation and at 2 and 36 weeks of postoperation; Hyperinsulinemic euglycemic clamps (HIEC) was conducted before operation and at 2 and 36 weeks of postoperation to calculate the endogenous hepatic glucose production (HGP) at the basal and steady-state for evaluation of hepatic insulin sensitivity, and calculate the exogenous glucose infusion rate (GIR) at the steady-state for evaluation of peripheral insulin sensitivity. Results The data showed that compared with rats in the sham and control groups, rats in SG group had 1) significantly lower AUCITT, HOMA-IR and AUC PCT values at 2 and 36 weeks of postoperation, 2) lower basal state HGP, but not steady-state GIR at 2 weeks of postoperation, and 3) significantly different basal and steady-state HGP and steady-state GIR at 36 weeks of postoperation. In addition, the basal and steady-state HGP and the steady-state GIR were significantly different between rats in SG group at 2 and 36 weeks of postoperation. Conclusions This study explored insulin sensitivity of rats after SG by jointly using a variety of techniques. The results showed that SG time-dependently improved the hepatic and peripheral insulin sensitivity.

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