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Diabetes. 2020 Jan 8. pii: db190773. doi: 10.2337/db19-0773. [Epub ahead of print]

Bariatric Surgery Rapidly Decreases Cardiac Dietary Fatty Acid Partitioning and Hepatic Insulin Resistance Through Increased Intra-abdominal Adipose Tissue Storage and Reduced Spillover in Type 2 Diabetes.

Author information

1
Division of Endocrinology, Department of Medicine, Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
2
Centre de recherche de l'Institut universitaire de cardiologie et pneumologie de Québec, Quebec City, Quebec, Canada.
3
Department of NuclearMedicine and Radiobiology, Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Université de Sherbrooke, Quebec, Canada.
4
Research Center on Aging, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
5
School of Nutrition, Université Laval, Québec, Québec, Canada.
6
Division of Endocrinology, Department of Medicine, Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Quebec, Canada andre.carpentier@usherbrooke.ca.

Abstract

Reduced storage of dietary fatty acids (DFA) in abdominal adipose tissues with their enhanced cardiac partitioning has been shown in subjects with type 2 diabetes (T2D) and pre-diabetes. We measured DFA metabolism and organ partitioning using positron-emission-tomography with oral and i.v.long-chain fatty acid and glucose tracers during a standard liquid meal in 12 obese subjects with T2D prior to and 8 to 12 days after bariatric surgery (sleeve gastrectomy and biliopancreatic diversion). Bariatric surgery reduced cardiac DFA uptake (from 1.75 [1.39-2.57] (median [interquartile range]) before to 1.09 [1.04-1.53] standard uptake value (SUV) after surgery, P< 0.01) and systemic DFA spillover (from 56.7 before to 24.7mmol over 6h after meal intake after surgery; P =0.01) with significant increase in intra-abdominal adipose tissue DFA uptake (from 0.15 [0.04-0.31] before to 0.49 [0.20-0.59] SUV after surgery, P=0.008). Hepatic insulin resistance was significantly reduced in close association with increased DFA storage in intra-abdominal adipose tissues (r = -0.79, P = 0.05) and reduced DFA spillover (r = 0.76, P = 0.01).We conclude that bariatric surgery in T2D subjects rapidly reduces cardiac DFA partitioning and hepatic insulin resistance at least in part through increased intra-abdominal DFA storage and reduced spillover.

PMID:
31915151
DOI:
10.2337/db19-0773

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