Format

Send to

Choose Destination
Front Immunol. 2017 Nov 15;8:1512. doi: 10.3389/fimmu.2017.01512. eCollection 2017.

Effect of Roux-en-Y Bariatric Surgery on Lipoproteins, Insulin Resistance, and Systemic and Vascular Inflammation in Obesity and Diabetes.

Author information

1
Cardiovascular Research Group, Core Technologies Facility, The University of Manchester, Manchester, United Kingdom.
2
Department of Metabolism, Endocrinology and Diabetes, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
3
Department of Endocrinology and Diabetes, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
4
Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
5
Department of Biochemistry, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
6
The Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, United Kingdom.
7
Weill Cornell Medicine-Qatar, Doha, Qatar.
8
Department of Surgery, Salford Royal NHS Foundation Trust, Salford, United Kingdom.

Abstract

Purpose:

Obesity is a major modifiable risk factor for cardiovascular disease. Bariatric surgery is considered to be the most effective treatment option for weight reduction in obese patients with and without type 2 diabetes (T2DM).

Objective:

To evaluate changes in lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction following Roux-en-Y bariatric surgery in obese patients with and without diabetes.

Materials and methods:

Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction were measured in 37 obese patients with (n = 17) and without (n = 20) T2DM, before and 6 and 12 months after Roux-en-Y bariatric surgery. Two way between subject ANOVA was carried out to study the interaction between independent variables (time since surgery and presence of diabetes) and all dependent variables.

Results:

There was a significant effect of time since surgery on (large effect size) weight, body mass index (BMI), waist circumference, triglycerides (TG), small-dense LDL apolipoprotein B (sdLDL ApoB), HOMA-IR, CRP, MCP-1, ICAM-1, E-selectin, P-selectin, leptin, and adiponectin. BMI and waist circumference had the largest impact of time since surgery. The effect of time since surgery was noticed mostly in the first 6 months. Absence of diabetes led to a significantly greater reduction in total cholesterol, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol although the effect size was small to medium. There was a greater reduction in TG and HOMA-IR in patients with diabetes with a small effect size. No patients were lost to follow up.

Conclusion:

Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction improve mostly 6 months after bariatric surgery in obese patients with and without diabetes.

Clinical Trial Registration:

www.ClinicalTrials.gov, identifier: NCT02169518. https://clinicaltrials.gov/ct2/show/NCT02169518?term=paraoxonase&cntry1=EU%3AGB&rank=1.

KEYWORDS:

Roux-en-Y; diabetes; insulin resistance; lipoproteins; vascular inflammation

Supplemental Content

Full text links

Icon for Frontiers Media SA Icon for PubMed Central
Loading ...
Support Center