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J Clin Endocrinol Metab. 2014 Aug;99(8):E1466-70. doi: 10.1210/jc.2014-1074. Epub 2014 Apr 29.

Adipocyte size threshold matters: link with risk of type 2 diabetes and improved insulin resistance after gastric bypass.

Author information

1
Sorbonne Universities (A.C., C.P., K.C.), University Pierre et Marie Curie-Paris 6, UMR_S U1166, Nutriomics, F-75013 Paris, France; Institute of Cardiometabolism and Nutrition, ICAN, AP-HP (A.C., C.P., C.G., K.C.), Pitié-Salpêtrière hospital, F-75013 Paris, France; INSERM, UMR_S U1166 (A.C., C.P., K.C.), Nutriomics, F-75013 Paris, France; Assistance Publique-Hôpitaux de Paris (A.T.), Pitié-Salpêtrière hospital, Surgery Department, F-75013 Paris, France; Assistance Publique-Hôpitaux de Paris (J.-L.B.), Ambroise Paré Hospital, Surgery Department, F-92012 Boulogne-Billancourt, France; Department of Surgery (A.D.), University of Leipzig, 04003-04357 Leipzig, Germany; Department of Medicine (N.K., M.B.), University of Leipzig, 04003-04357 Leipzig, Germany; and Junior Research Group Animal Models (N.K.), IFB Obesity Diseases, University of Leipzig, 04003-04357 Leipzig, Germany; AdipoPhyt (K.L.), F-75013 Paris, France.

Abstract

CONTEXT:

Adipocyte volume has been associated with insulin resistance and type 2 diabetes.

OBJECTIVE:

Our purpose was to identify an adipocyte volume threshold linked with increased insulin resistance risk, and to examine its association with insulin resistance improvement after bariatric surgery.

SETTING AND DESIGN:

We investigated two cohorts of Caucasian women, candidates for bariatric surgery, from two institutional centers in France (age 42.0 ± 11.5 years; body mass index, 47.6 ± 6.9 kg/m(2)) and Germany (age 41.3 ± 11.2 years; body mass index, 49.5 ± 8.1 kg/m(2)). 38% of the subjects had gastric bypass surgery and were followed for 6 months after the intervention. We defined a group of subjects with type 2 diabetes or at risk of type 2 diabetes (DRD) and investigated the relations between adipocyte volume and this status before and after surgery.

RESULTS:

In both cohorts, subjects with DRD presented enlarged adipocytes (France, P = 3×10(-4); Germany, P =3×10(-10)) and we were able to determine thresholds in each cohort above which diabetes risk was potentially increased (France: 1003±42 pL, Germany: 798±32 pL). Subjects above those adipocyte thresholds were less prone to disappearance of the DRD status after bypass surgery (France, risk ratio = 2.1, P = .024; Germany, risk ratio = 1.3, P = .05).

CONCLUSIONS:

We show in two cohorts of morbidly obese subjects that a specific adipocyte volume threshold may predict an increased risk for obesity-associated type 2 diabetes. However, this threshold might be established for each specific investigation site. Having a high adipocyte size is associated with a lower improvement of insulin resistance after bypass surgery in both cohorts.

PMID:
24780048
DOI:
10.1210/jc.2014-1074
[Indexed for MEDLINE]

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