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.
Keywords: Adipose tissue; Bariatric surgery; Inflammation; Morbid obesity; TNF-α; Type 2 diabetes mellitus.
Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.