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Type: Artigo de periódico
Title: Comparison of Metabolic Effects of Surgical-Induced Massive Weight Loss in Patients with Long-Term Remission Versus Non-remission of Type 2 Diabetes
Author: Hirsch, FF
Pareja, JC
Geloneze, SR
Chaim, E
Cazzo, E
Geloneze, B
Abstract: The aim of this study was to evaluate the pathophysiological mechanisms underlying the non-remission of type 2 diabetes in Roux-en-Y gastric bypass (RYGB) patients. A group of patients not in remission (NR) was formed ( = 13). A remission group (R) was composed of patients who had undergone normalization of fasting glycemia and A1c, without anti-diabetic drugs and matched for selected baseline characteristics (i.e., duration of disease, previous BMI, final BMI, fat distribution, and age; = 15). A control group of lean subjects ( = 41) was formed. The NR group had higher uric acid (5.1 vs. 3.9 mg/dL), number of leukocytes (6,866.9 vs. 5,423.6), hs-CRP (0.27 vs. 0.12 mg/dL), MCP-1 (118.4 vs. 64.4 ng/mL), HOMA-IR, and AUC(glucose) but lower adiponectin (9.4 vs. 15.4 ng/mL), leptin (12.7 vs. 20.7 ng/mL), and AUC(GLP-1) in comparison to R group; the NR group also had lower leptin and higher adiponectin, HOMA-IR, AUC(glucose), AUC(C-peptide), AUC(glucagon), and AUC(GLP-1) than controls. The R group had lower MCP-1 and higher adiponectin compared to controls. Insulin sensitivity was significantly lower in the NR group than in the R and control groups. The insulin secretion index values were lower in the NR group than in the R and control groups. This study found greater insulin resistance, lower insulin secretion, persistent adiposopathy and chronic subclinical inflammation, and less robust incretin response in the NR group despite a similar level of weight loss. Persistently altered pathophysiological mechanisms can be related to the lack of remission of type 2 diabetes after RYGB.
Subject: Diabetes
Bariatric surgery
Monocyte chemoattractant protein (MCP-1)
insulin resistance
Country: EUA
Editor: Springer
Citation: Obesity Surgery. Springer, v. 22, n. 6, n. 910, n. 917, 2012.
Rights: fechado
Identifier DOI: 10.1007/s11695-012-0589-0
Date Issue: 2012
Appears in Collections:Unicamp - Artigos e Outros Documentos

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