EFFECTS OF BARIATRIC SURGERY ON INSULIN SENSITIVITY AND SYMPATHETIC NERVE TRAFFIC IN OBESE SUBJECTS. A LONGITUDINAL STUDY

IntroductionAlterations in linear and non-linear parameters of beat-to-beat blood pressure variability (BPV) have been shown to predict disease prognosis and distinguish between risk categories in various pathological conditions, independently of average blood pressure levels. Obesity places subjects at elevated risk of vascular diseases, including hypertension, resulting in serious cardiac, respiratory and cerebral events. However, little is known about the status of vascular dynamics in obese and morbidly obese adults.Methods and analysisIn this present quasi-experimental longitudinal study, changes in beat-to-beat BPV, using continuous, non-invasive blood pressure monitoring, in obese subjects undergoing bariatric surgery are characterised. The capacity of linear and non-linear measures of BPV to detect differences between hypertensive, prehypertensive and normotensive obese subjects prebariatric and postbariatric surgery are tested. Additionally, potential correlations between beat-to-beat BPV and age, body mass index, gender and comorbidities will be investigated. In parallel, the impact of the unsteady fluctuations of beat-to-beat blood pressure on the dynamic stresses imparted by blood flow on blood vessel walls will be explored. We expect to find altered BPV profiles in hypertensive and prehypertensive subjects as compared with normotensive subjects. We also expect to see differential normalisation in BPV profiles between hypertensive, prehypertensive and normotensive subjects over time.Ethics and disseminationThe study has been approved by the Institutional Review Board at the American University of Beirut (IRB ID: BIO-2018-0040). Study results will be made available to the public through publications in peer-reviewed journals and conference papers and/or presentations.

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γ-Glutamyltransferase Fractions in Obese Subjects with Type 2 Diabetes: Relation to Insulin Sensitivity and Effects of Bariatric Surgery

Obesity Surgery ◽

10.1007/s11695-017-3017-7 ◽

2017 ◽

Vol 28 (5) ◽

pp. 1363-1371 ◽

Cited By ~ 3

Author(s):

Maria Franzini ◽

Veronica Musetti ◽

Daniela Guarino ◽

Laura Caponi ◽

Aldo Paolicchi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Insulin Sensitivity ◽

Obese Subjects

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Human Bone Marrow Adipose Tissue is a Metabolically Active and Insulin-Sensitive Distinct Fat Depot

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa216 ◽

2020 ◽

Vol 105 (7) ◽

pp. 2300-2310 ◽

Cited By ~ 2

Author(s):

Tam T Pham ◽

Kaisa K Ivaska ◽

Jarna C Hannukainen ◽

Kirsi A Virtanen ◽

Martin E Lidell ◽

...

Keyword(s):

Bariatric Surgery ◽

Bone Marrow ◽

Adipose Tissue ◽

Insulin Sensitivity ◽

Whole Body ◽

Morbidly Obese ◽

Bone Marrow Adipose Tissue ◽

Marrow Adipose Tissue ◽

Obese Subjects ◽

Fat Depot

Abstract Context Bone marrow (BM) in adult long bones is rich in adipose tissue, but the functions of BM adipocytes are largely unknown. We set out to elucidate the metabolic and molecular characteristics of BM adipose tissue (BMAT) in humans. Objective Our aim was to determine if BMAT is an insulin-sensitive tissue, and whether the insulin sensitivity is altered in obesity or type 2 diabetes (T2DM). Design This was a cross-sectional and longitudinal study. Setting The study was conducted in a clinical research center. Patients or Other Participants Bone marrow adipose tissue glucose uptake (GU) was assessed in 23 morbidly obese subjects (9 with T2DM) and 9 healthy controls with normal body weight. In addition, GU was assessed in another 11 controls during cold exposure. Bone marrow adipose tissue samples for molecular analyses were collected from non-DM patients undergoing knee arthroplasty. Intervention(s) Obese subjects were assessed before and 6 months after bariatric surgery and controls at 1 time point. Main Outcome Measure We used positron emission tomography imaging with 2-[18F]fluoro-2-deoxy-D-glucose tracer to characterize GU in femoral and vertebral BMAT. Bone marrow adipose tissue molecular profile was assessed using quantitative RT-PCR. Results Insulin enhances GU in human BMAT. Femoral BMAT insulin sensitivity was impaired in obese patients with T2DM compared to controls, but it improved after bariatric surgery. Furthermore, gene expression analysis revealed that BMAT was distinct from brown and white adipose tissue. Conclusions Bone marrow adipose tissue is a metabolically active, insulin-sensitive and molecularly distinct fat depot that may play a role in whole body energy metabolism.

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Differential Effects of Bariatric Surgery on Plasma Levels of ANGPTL3 and ANGPTL4.

10.21203/rs.3.rs-1017161/v1 ◽

2021 ◽

Author(s):

Simone Bini ◽

Laura D’Erasmo ◽

Brenno Astiarraga ◽

Ilenia Minicocci ◽

Maria Palumbo ◽

...

Keyword(s):

Bariatric Surgery ◽

Insulin Sensitivity ◽

Fat Mass ◽

Plasma Levels ◽

Fold Increase ◽

Morbidly Obese ◽

Euglycemic Hyperinsulinemic Clamp ◽

Obese Subjects ◽

The Impact ◽

Fat Mass Loss

Abstract Introduction: Angiopoietin-like protein 3 (ANGPTL3) and 4 (ANGPTL4) are regulators of triglycerides storage and utilization. Bariatric surgery (BS) determines profound changes in adipose tissue composition and energy metabolism. We evaluated the impact of BS on plasma levels of ANGPTL3 and ANGPTL4.Method: Twenty-seven morbidly obese subjects with or without type 2 diabetes (T2D) underwent Roux-en-Y gastric bypass (RYGB) and 18 patients with advanced T2D received Biliopancreatic Diversion (BPD). Fasting ANGPTLs levels, insulin sensitivity (evaluated by euglycemic hyperinsulinemic clamp), total bile acids (TBA) and free fatty acids (FFA) were measured at baseline and 1year after surgery.Results: Both surgical procedures resulted in fat mass loss, improved glucose control, and a ~2-fold increase of insulin sensitivity. ANGPTL4 levels decreased significantly with both RYGB (26.6 ± 0.6 to 24.4 ± 0.3 ng/mL, p=0.001) and BPD (27.9 ± 1.5 to 24.0 ± 0.5 ng/mL, p=0.003). In contrast, ANGPTL3 concentrations did not change after RYGB but rose following BPD (225 ± 20 to 300 ± 15 ng/mL, p=0.003). By multiple regression analysis, changes in ANGPTL4 were independently associated with those of blood glucose, p=0.0169) whereas changes in ANGPTL3 after BPD were associated with variations in FFA (p=0.008) and insulin sensitivity (p=0.0427). Discussion: Circulating ANGPTL4 is reduced by BS probably due to the loss of fat mass and improved insulin sensitivity. Conversely, ANGPTL3 levels increased after BPD, presumably because of the metabolic changes induced by the malabsorptive effect of this surgical procedure.

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W09.222 The effect of orlistat therapy on insulin sensitivity and doppler ultrasonography measures of femoral arteries blood flow in obese subjects

Atherosclerosis ◽

10.1016/s0021-9150(04)90221-3 ◽

2004 ◽

Vol 5 (1) ◽

pp. 52

Author(s):

Z HADUKOVIC

Keyword(s):

Blood Flow ◽

Insulin Sensitivity ◽

Doppler Ultrasonography ◽

Femoral Arteries ◽

Obese Subjects

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Abstract #724: Bariatric Surgery Restores Both Cardiac and Sudomotor Autonomic C-Fiber Dysfunction Towards Normal in Obese Subjects with Type 2 Diabetes

Endocrine Practice ◽

10.1016/s1530-891x(20)45133-x ◽

2016 ◽

Vol 22 ◽

pp. 159

Author(s):

Carolina Casellini ◽

Joshua Edwards ◽

Henri Parson ◽

Kim Hodges ◽

David Lieb ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

C Fiber ◽

Obese Subjects

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Epigenetic and Metabolic Changes in Skeletal Muscle Underlying the Improvement of Insulin Sensitivity after Bariatric Surgery in Humans

Diabetes ◽

10.2337/db18-156-or ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 156-OR

Author(s):

SOFIYA GANCHEVA ◽

MERIEM OUNI ◽

CHRYSI KOLIAKI ◽

TOMAS JELENIK ◽

DANIEL F. MARKGRAF ◽

...

Keyword(s):

Bariatric Surgery ◽

Skeletal Muscle ◽

Insulin Sensitivity ◽

Metabolic Changes

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Changes in the Composition and Function of Lipoproteins after Bariatric Surgery in Patients with Severe Obesity

Journal of Clinical Medicine ◽

10.3390/jcm10081716 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1716

Author(s):

Idoia Genua ◽

Núria Puig ◽

Inka Miñambres ◽

Sonia Benítez ◽

Pedro Gil ◽

...

Keyword(s):

Bariatric Surgery ◽

Lipid Profile ◽

Healthy Subjects ◽

Control Group ◽

Morbidly Obese ◽

Qualitative Properties ◽

Ldl Particles ◽

Obese Subjects ◽

Lipoprotein Composition ◽

Qualitative Characteristics

The effect of bariatric surgery on lipid profile and the qualitative characteristics of lipoproteins was analyzed in morbidly obese subjects. Thirteen obese patients underwent bariatric surgery. Plasma samples were obtained before surgery and at 6 and 12 months after the intervention. Thirteen healthy subjects comprised the control group. Lipid profile, hsCRP, and the composition and functional characteristics of VLDL, LDL, and HDL were assessed. At baseline, plasma from subjects with obesity had more triglycerides, VLDLc, and hsCRP, and less HDLc than the control group. These levels progressively normalized after surgery, although triglyceride and hsCRP levels remained higher than those in the controls. The main differences in lipoprotein composition between the obese subjects and the controls were increased apoE in VLDL, and decreased cholesterol and apoJ and increased apoC-III content in HDL. The pro-/anti-atherogenic properties of LDL and HDL were altered in the subjects with obesity at baseline compared with the controls, presenting smaller LDL particles that are more susceptible to modification and smaller HDL particles with decreased antioxidant capacity. Bariatric surgery normalized the composition of lipoproteins and improved the qualitative characteristics of LDL and HDL. In summary, patients with obesity present multiple alterations in the qualitative properties of lipoproteins compared with healthy subjects. Bariatric surgery reverted most of these alterations.

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Improvements in cholesterol efflux capacity of HDL and adiponectin contribute to mitigation in cardiovascular disease risk after bariatric surgery in a cohort with morbid obesity

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00662-3 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Himani Thakkar ◽

Vinnyfred Vincent ◽

Sakshi Sukhla ◽

Manraj Sra ◽

Uma Kanga ◽

...

Keyword(s):

Cardiovascular Disease ◽

Bariatric Surgery ◽

Insulin Sensitivity ◽

Cholesterol Efflux ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cvd Risk ◽

Cholesterol Efflux Capacity ◽

Post Surgery ◽

Inflammatory Status

Abstract Background Bariatric surgery can alleviate cardiovascular risk via effects on cardiovascular disease (CVD) risk factors such as diabetes mellitus, hypertension, and dyslipidemia. Our study aimed to assess the cholesterol efflux capacity (CEC) of HDL as a negative risk factor for CVD in individuals with obesity and identify the factors associated with improvement in CEC 3 months following bariatric surgery. Methods We recruited 40 control individuals (mean BMI of 22.2 kg/m2) and 56 obese individuals (mean BMI of 45.9 kg/m2). The biochemical parameters, inflammatory status and CEC of HDL was measured for the obese individuals before bariatric surgery and at 3 months after surgery. The CEC was measured using a cell-based cholesterol efflux system of BODIPY-cholesterol-labelled THP-1 macrophages. Results A significant reduction in BMI (− 17%, p < 0.001), resolution of insulin sensitivity (HOMA2-IR = − 23.4%, p = 0.002; Adipo IR = − 16%, p = 0.009) and inflammation [log resistin = − 6%, p = 0.07] were observed 3 months post-surgery. CEC significantly improved 3 months after surgery [Pre: 0.91 ± 0.13; Post: 1.02 ± 0.16; p = 0.001] despite a decrease in HDL-C levels. The change in CEC correlated with the change in apo A-I (r = 0.39, p = 0.02) and adiponectin levels (r = 0.35, p = 0.03). Conclusion The results suggest that improvements in CEC, through improvement in adipose tissue health in terms of adipokine secretion and insulin sensitivity could be an important pathway in modulating obesity-related CVD risk.

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