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5. Mid- and long-term renal outcomes after metabolic surgery in a multi-center, multi-ethnic Asian cohort with T2DM.

Author

Sio, Yueh-Chu, Chen, Ching-Yi, Huang, Yu-Min, Lee, Wei-Jei, Hur, Kyoung Yul, Kasama, Kazunori, Cheng, Anton Kui Sing, Lee, Ming-Hsien, Simon, Kin-Hung Wong, Soong, Tien-Chou, Lee, Kuo-Ting, Lomanto, Davide, Lakdawala, Muffazal, Su, Yen-Hao, Wang, Weu, and Chen, Hsi-Hsien

Abstract

Background Metabolic surgery is recognized for its effectiveness in weight loss and improving outcomes for individuals with type 2 diabetes mellitus (T2DM). However, its impact on renal function, especially in multi-ethnic Asian populations, remains underexplored. This study investigates mid- and long-term renal outcomes following metabolic surgery in Asian patients with T2DM. Methods This retrospective cohort study utilized data from the Asian Diabetes Surgery Study (ADSS), involving T2DM patients aged 20–79 who underwent metabolic surgery from 2008 to 2015. The primary outcome was the change in estimated glomerular filtration rate (eGFR) at 1, 3, and 5 years post-surgery, with adjustments for confounders. Secondary outcomes included changes in chronic kidney disease (CKD) stages and the relationship between weight loss and eGFR changes. Data were analyzed using univariate and multivariable regression analyses, along with the McNemar test. Results The study included 1513 patients with a mean age of 42.7 years. The results revealed that a significant improvement in eGFR was observed at 1-year post-surgery (112.4 ± 32.0 ml/min/1.73 m², P < .001), with a shift toward less severe CKD stages. However, this improvement was not sustained at 3 and 5 years. No significant correlation was found between weight loss and eGFR changes at 1-year follow-up. Conclusion Metabolic surgery significantly improves renal function at 1 year postoperatively in Asian individuals with T2DM, highlighting its potential benefits beyond glycemic control and weight loss. The long-term effects on renal function require further investigation. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Current recommendations for procedure selection in class I and II obesity developed by an expert modified Delphi consensus

Author

Kermansaravi, Mohammad, primary, Chiappetta, Sonja, additional, Parmar, Chetan, additional, Shikora, Scott A., additional, Prager, Gerhard, additional, LaMasters, Teresa, additional, Ponce, Jaime, additional, Kow, Lilian, additional, Nimeri, Abdelrahman, additional, Kothari, Shanu N., additional, Aarts, Edo, additional, Abbas, Syed Imran, additional, Aly, Ahmad, additional, Aminian, Ali, additional, Bashir, Ahmad, additional, Behrens, Estuardo, additional, Billy, Helmuth, additional, Carbajo, Miguel A., additional, Clapp, Benjamin, additional, Chevallier, Jean-Marc, additional, Cohen, Ricardo V., additional, Dargent, Jerome, additional, Dillemans, Bruno, additional, Faria, Silvia L., additional, Neto, Manoel Galvao, additional, Garneau, Pierre Y., additional, Gawdat, Khaled, additional, Haddad, Ashraf, additional, ElFawal, Mohamad Hayssam, additional, Higa, Kelvin, additional, Himpens, Jaques, additional, Husain, Farah, additional, Hutter, Matthew M., additional, Kasama, Kazunori, additional, Kassir, Radwan, additional, Khan, Amir, additional, Khoursheed, Mousa, additional, Kroh, Matthew, additional, Kurian, Marina S., additional, Lee, Wei-Jei, additional, Loi, Ken, additional, Mahawar, Kamal, additional, McBride, Corrigan L., additional, Almomani, Hazem, additional, Melissas, John, additional, Miller, Karl, additional, Misra, Monali, additional, Musella, Mario, additional, Northup, C. Joe, additional, O’Kane, Mary, additional, Papasavas, Pavlos K., additional, Palermo, Mariano, additional, Peterson, Richard M., additional, Peterli, Ralph, additional, Poggi, Luis, additional, Pratt, Janey S. A., additional, Alqahtani, Aayad, additional, Ramos, Almino C., additional, Rheinwalt, Karl, additional, Ribeiro, Rui, additional, Rogers, Ann M., additional, Safadi, Bassem, additional, Salminen, Paulina, additional, Santoro, Sergio, additional, Sann, Nathaniel, additional, Scott, John D., additional, Shabbir, Asim, additional, Sogg, Stephanie, additional, Stenberg, Erik, additional, Suter, Michel, additional, Torres, Antonio, additional, Ugale, Surendra, additional, Vilallonga, Ramon, additional, Wang, Cunchuan, additional, Weiner, Rudolf, additional, Zundel, Natan, additional, Angrisani, Luigi, additional, and De Luca, Maurizio, additional

Published
2024
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13. Deficiency of NPGPx, an oxidative stress sensor, leads to obesity in mice and human

Author

Chang, Yi-Cheng, Yu, Yu-Hsiang, Shew, Jin-Yuh, Lee, Wei-Jei, Hwang, Juey-Jen, Chen, Yen-Hui, Chen, Yet-Ran, Wei, Pei-Chi, Chuang, Lee-Ming, and Lee, Wen-Hwa

Subjects
Adipogenesis, C/Ebp, N-Acetylcysteine, Npgpx, Oxidative StressAlpha-Lipoic Acid, Diet-Induced Obesity, Body-Mass Index, Glutathione-Peroxidase, Adipocyte Differentiation, Insulin-Resistance, Metabolic Syndrome, Cell-Death, Protects, Association
Published
2013

21. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for type 2 diabetes remission (ORDER): protocol of a multicentre, randomised controlled, open-label, superiority trial

Author

Li, Mengyi, primary, Liu, Yang, additional, Lee, Wei-Jei, additional, Shikora, Scott A, additional, Robert, Maud, additional, Wang, Weu, additional, Wong, Simon Kin Hung, additional, Kong, Yuanyuan, additional, Tong, Daniel King Hung, additional, Tan, Chun Hai, additional, Zeng, Na, additional, Zhu, Shaihong, additional, Wang, Cunchuan, additional, Zhang, Pin, additional, Gu, Yan, additional, Bai, Rixing, additional, Meng, Fanqiang, additional, Mao, Zhongqi, additional, Zhao, Xiangwen, additional, Wu, Liangping, additional, Liu, Yanjun, additional, Zhang, Songhai, additional, Zhang, Peng, additional, and Zhang, Zhongtao, additional

Published
2022
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24. Outcomes of the first global multidisciplinary consensus meeting including persons living with obesity to standardize patient-reported outcome measurement in obesity treatment research

Author

de Vries, Claire E. E., Terwee, Caroline B., Al Nawas, May, van Wagensveld, Bart A., Janssen, Ignace M. C., Liem, Ronald S. L., Nienhuijs, Simon W., Cohen, Ricardo, V, van Rossum, Elisabeth F. C., Brown, Wendy A., Ghaferi, Amir A., Ottosson, Johan, Coulman, Karen D., Petry, Tarissa B. Z., Sogg, Stephanie, West-Smith, Lisa, Halford, Jason C. G., Salas, Ximena Ramos, Dixon, John B., Al-Sabah, Salman, Lee, Wei-Jei, Andersen, John Roger, Flint, Stuart W., Hoogbergen, Maarten M., Backman, Brooke, Govers, Ellen, Isack, Nadya, Clay, Caroline, Birney, Susie, Gunn, Maureen, Masterson, Paul, Roberts, Audrey, Nesbitt, Jacky, Meloni, Riccardo, le Brocq, Sarah, de Blaeij, Sandra, Kraaijveld, Christina, van der Steen, Floor, Visser, Bibian, Hamers, Petra, Monpellier, Valerie M., de Vries, Claire E. E., Terwee, Caroline B., Al Nawas, May, van Wagensveld, Bart A., Janssen, Ignace M. C., Liem, Ronald S. L., Nienhuijs, Simon W., Cohen, Ricardo, V, van Rossum, Elisabeth F. C., Brown, Wendy A., Ghaferi, Amir A., Ottosson, Johan, Coulman, Karen D., Petry, Tarissa B. Z., Sogg, Stephanie, West-Smith, Lisa, Halford, Jason C. G., Salas, Ximena Ramos, Dixon, John B., Al-Sabah, Salman, Lee, Wei-Jei, Andersen, John Roger, Flint, Stuart W., Hoogbergen, Maarten M., Backman, Brooke, Govers, Ellen, Isack, Nadya, Clay, Caroline, Birney, Susie, Gunn, Maureen, Masterson, Paul, Roberts, Audrey, Nesbitt, Jacky, Meloni, Riccardo, le Brocq, Sarah, de Blaeij, Sandra, Kraaijveld, Christina, van der Steen, Floor, Visser, Bibian, Hamers, Petra, and Monpellier, Valerie M.

Abstract

Quality of life is a key outcome that is not rigorously measured in obesity treatment research due to the lack of standardization of patient-reported outcomes (PROs) and PRO measures (PROMs). The S.Q.O.T. initiative was founded to Standardize Quality of life measurement in Obesity Treatment. A first face-to-face, international, multidisciplinary consensus meeting was conducted to identify the key PROs and preferred PROMs for obesity treatment research. It comprised of 35 people living with obesity (PLWO) and healthcare providers (HCPs). Formal presentations, nominal group techniques, and modified Delphi exercises were used to develop consensus-based recommendations. The following eight PROs were considered important: self-esteem, physical health/functioning, mental/psychological health, social health, eating, stigma, body image, and excess skin. Self-esteem was considered the most important PRO, particularly for PLWO, while physical health was perceived to be the most important among HCPs. For each PRO, one or more PROMs were selected, except for stigma. This consensus meeting was a first step toward standardizing PROs (what to measure) and PROMs (how to measure) in obesity treatment research. It provides an overview of the key PROs and a first selection of the PROMs that can be used to evaluate these PROs., Funding agencies:Johnson & Johnson USA Philips Vital Health Castor Bart Torensma

Published
2022
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25. Outcomes of the first global multidisciplinary consensus meeting including persons living with obesity to standardize patient-reported outcome measurement in obesity treatment research

Author

de Vries, Claire E.E., Terwee, Caroline B., Al Nawas, May, van Wagensveld, Bart A., Janssen, Ignace M.C., Liem, Ronald S.L., Nienhuijs, Simon W., Cohen, Ricardo V., van Rossum, Elisabeth F.C., Brown, Wendy A., Ghaferi, Amir A., Ottosson, Johan, Coulman, Karen D., Petry, Tarissa B.Z., Sogg, Stephanie, West-Smith, Lisa, Halford, Jason C.G., Salas, Ximena Ramos, Dixon, John B., Al-Sabah, Salman, Lee, Wei Jei, Andersen, John Roger, Flint, Stuart W., Hoogbergen, Maarten M., Backman, Brooke, Govers, Ellen, Isack, Nadya, Clay, Caroline, Birney, Susie, Gunn, Maureen, Masterson, Paul, Roberts, Audrey, Nesbitt, Jacky, Meloni, Riccardo, le Brocq, Sarah, de Blaeij, Sandra, Kraaijveld, Christina, van der Steen, Floor, Visser, Bibian, Hamers, Petra, Monpellier, Valerie M., de Vries, Claire E.E., Terwee, Caroline B., Al Nawas, May, van Wagensveld, Bart A., Janssen, Ignace M.C., Liem, Ronald S.L., Nienhuijs, Simon W., Cohen, Ricardo V., van Rossum, Elisabeth F.C., Brown, Wendy A., Ghaferi, Amir A., Ottosson, Johan, Coulman, Karen D., Petry, Tarissa B.Z., Sogg, Stephanie, West-Smith, Lisa, Halford, Jason C.G., Salas, Ximena Ramos, Dixon, John B., Al-Sabah, Salman, Lee, Wei Jei, Andersen, John Roger, Flint, Stuart W., Hoogbergen, Maarten M., Backman, Brooke, Govers, Ellen, Isack, Nadya, Clay, Caroline, Birney, Susie, Gunn, Maureen, Masterson, Paul, Roberts, Audrey, Nesbitt, Jacky, Meloni, Riccardo, le Brocq, Sarah, de Blaeij, Sandra, Kraaijveld, Christina, van der Steen, Floor, Visser, Bibian, Hamers, Petra, and Monpellier, Valerie M.

Abstract

Quality of life is a key outcome that is not rigorously measured in obesity treatment research due to the lack of standardization of patient-reported outcomes (PROs) and PRO measures (PROMs). The S.Q.O.T. initiative was founded to Standardize Quality of life measurement in Obesity Treatment. A first face-to-face, international, multidisciplinary consensus meeting was conducted to identify the key PROs and preferred PROMs for obesity treatment research. It comprised of 35 people living with obesity (PLWO) and healthcare providers (HCPs). Formal presentations, nominal group techniques, and modified Delphi exercises were used to develop consensus-based recommendations. The following eight PROs were considered important: self-esteem, physical health/functioning, mental/psychological health, social health, eating, stigma, body image, and excess skin. Self-esteem was considered the most important PRO, particularly for PLWO, while physical health was perceived to be the most important among HCPs. For each PRO, one or more PROMs were selected, except for stigma. This consensus meeting was a first step toward standardizing PROs (what to measure) and PROMs (how to measure) in obesity treatment research. It provides an overview of the key PROs and a first selection of the PROMs that can be used to evaluate these PROs.

Published
2022

34. Severe obesity is associated with novel single nucleotide polymorphisms of the ESR1 and PPAR[gamma] locus in Han Chinese

Author

Chen, Hsin-Hung, Lee, Wei-Jei, Fann, Cathy S.J., Bouchard, Claude, and Pan, Wen-Harn

Subjects
Obesity -- Genetic aspects, Obesity -- Risk factors, Obesity -- Research, Single nucleotide polymorphisms -- Research, Estrogen -- Receptors, Estrogen -- Genetic aspects, Estrogen -- Research, Food/cooking/nutrition, Health
Abstract

Background: A large number of potential obesity loci have been reported. At least 18 genes have been replicated in a minimum of 5 studies on obesity-related phenotypes. Fourteen additional genes have been associated with obesity in Asians. Objectives: Our objectives were to examine how many common variants of these candidate genes are associated with severe obesity in Han Chinese and how they are combined to exert their effects. Design: In total, 304 severely obese patients [body mass index (BMI; in kg/[m.sup.2]) [greater than or equal to] 39] and 304 control subjects (BMI [less than or equal to] 24) participated in a 2-staged association study. Subsequently, 220 additional severely obese patients (BMI [greater than or equal to] 35) and 338 controls (BMI [less than or equal to] 24) were recruited to replicate the results. All of the controls were age-, sex-, education- and residence-matched. Finally, a pooled analysis was carried out based on all 514 cases and 606 controls with complete information. Results: The first-stage association analysis in 94 cases and 94 controls found 18 potentially associated single nucleotide polymorphisms (SNPs) (P = 0.01-0.1). The significance of 3 novel common SNPs, 1 on ESR1 and 2 on PPAR[gamma], were confirmed in the second stage and replicated further with odds ratios ranging from 1.89 to 2.24. The combined effect of these 3 genes was stronger (odds ratio: 5.27; 95% CI: 2.25, 12.32) than that from any individual gene. Conclusions: Severe obesity in Han Chinese was associated with 3 novel common SNPs for ESR1 and PPAR[gamma]. These 2 genes collectively result in a >5-fold risk of severe obesity. This information may contribute to the assessment of risk of severe obesity. Am J Clin Nutr 2009;90:255-62.

Published
2009

37. Common ALDH2 genetic variants predict development of hypertension in the SAPPHIRe prospective cohort: Gene-environmental interaction with alcohol consumption

Author

Chang Yi-Cheng, Chiu Yen-Feng, Lee I-Te, Ho Low-Tone, Hung Yi-Jen, Hsiung Chao A, Quertermous Thomas, Donlon Timothy, Lee Wei-Jei, Lee Po-Chu, Chen Che-Hong, Mochly-Rosen Daria, and Chuang Lee-Ming

Subjects
ALDH2, Hypertension, SNP, Chinese, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Genetic variants near/within the ALDH2 gene encoding the mitochondrial aldehyde dehydrogenase 2 have been associated with blood pressure and hypertension in several case–control association studies in East Asian populations. Methods Three common tag single nucleotide polymorphisms (tagSNP) in the ALDH2 gene were genotyped in 1,134 subjects of Chinese origin from the Stanford Asia-Pacific Program for Hypertension and Insulin Resistance (SAPPHIRe) family cohort. We examined whether the ALDH2 SNP genotypes predicted the development of hypertension in the prospective SAPPHIRe cohort. Results Over an average follow-up period of 5.7 years, carriers homozygous for the rs2238152 T allele in the ALDH2 gene were more likely to progress to hypertension than were non-carriers (hazard ratio [HR], 2.88, 95% confidence interval [CI], 1.06-7.84, P = 0.03), corresponding to a population attributable risk of ~7.1%. The risk associated with the rs2238152 T allele were strongest in heavy/moderate alcohol drinkers and was reduced in non-drinkers, indicating an interaction between ALDH2 genetic variants and alcohol intake on the risk of hypertension (P for interaction = 0.04). The risk allele was associated with significantly lower ALDH2 gene expression levels in human adipose tissue. Conclusion ALDH2 genetic variants were associated with progression to hypertension in a prospective Chinese cohort. The association was modified by alcohol consumption.

Published
2012
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39. The First Consensus Statement on One Anastomosis/Mini Gastric Bypass (OAGB/MGB) Using a Modified Delphi Approach

Author

Mahawar, Kamal Kumar, Himpens, Jacques, Shikora, Scott, Chevallier, Jean Marc, Lakdawala, Mufazzal, De Luca, Maurizio, Weiner, Rudolf R.A., Khammas, Ali, Kular, Kuldeepak Singh, Musella, Mario, Prager, Gerhard, Mirza, Mohammad Khalid, Carbajo, Miguel, Kow, Lilian, Lee, Wei Jei, Small, Peter P.K., Mahawar, Kamal Kumar, Himpens, Jacques, Shikora, Scott, Chevallier, Jean Marc, Lakdawala, Mufazzal, De Luca, Maurizio, Weiner, Rudolf R.A., Khammas, Ali, Kular, Kuldeepak Singh, Musella, Mario, Prager, Gerhard, Mirza, Mohammad Khalid, Carbajo, Miguel, Kow, Lilian, Lee, Wei Jei, and Small, Peter P.K.

Abstract

Background: An increasing number of surgeons worldwide are now performing one anastomosis/mini gastric bypass (OAGB/MGB). Lack of a published consensus amongst experts may be hindering progress and affecting outcomes. This paper reports results from the first modified Delphi consensus building exercise on this procedure. Methods: A committee of 16 recognised opinion-makers in bariatric surgery with special interest in OAGB/MGB was constituted. The committee invited 101 OAGB/MGB experts from 39 countries to vote on 55 statements in areas of controversy or variation associated with this procedure. An agreement amongst ≥ 70.0% of the experts was considered to indicate a consensus. Results: A consensus was achieved for 48 of the 55 proposed statements after two rounds of voting. There was no consensus for seven statements. Remarkably, 100.0% of the experts felt that OAGB/MGB was an “acceptable mainstream surgical option” and 96.0% felt that it could no longer be regarded as a new or experimental procedure. Approximately 96.0 and 91.0% of the experts felt that OAGB/MGB did not increase the risk of gastric and oesophageal cancers, respectively. Approximately 94.0% of the experts felt that the construction of the gastric pouch should start in the horizontal portion of the lesser curvature. There was a consensus of 82, 84, and 85% for routinely supplementing iron, vitamin B12, and vitamin D, respectively. Conclusion: OAGB/MGB experts achieved consensus on a number of aspects concerning this procedure but several areas of disagreements persist emphasising the need for more studies in the future., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2018

40. DOES BARIATRIC SURGERY IMPACT PLASMA LEVELS OF FETUIN-A AND LEUOKOCYTE CELL-DERIVED CHEMOTAXIN-2 IN DIABETIC PATIENTS?

Author

Lee, Wei-Jei

Abstract

Background and Aims. Fetuin-A and leukocyte cell-derived chemotaxin-2 (LECT-2) are liver-derived proteins. Fetuin-A, is an independent risk factor for type 2 diabetes (T2D) and obese patients with T2D have higher plasma fetuin-A levels than those without T2D. LECT-2 has positive correlation with the severity of both obesity and insulin resistance. The changes in plasma fetuin-A are not consistent after bariatric surgery and no studies have investigated the changes in LECT-2 on the obese patients with T2D after bariatric surgery.Methods. Overall, 18 patients undergoing gastric bypass (GB) and 16 patients undergoing sleeve gastrectomy (SG) were enrolled. The fasting plasma fetuin-A and LECT-2 levels were measured baseline, one week, three months, and one year after surgery.Results. Both the GB and SG groups significantly decreased the body mass index (BMI), waist-to-hip ratio, fasting blood sugar (FBS), hemoglobin A1c, C-peptide levels; and homeostatic model assessment (HOMA-IR) one year after surgery. The SG group showed a decreasing trend in plasma fetuin-A levels one year after SG surgery. There are no significant changes in LECT-2 one year after either GB or SG. Changes in fetuin-A had a significant positive relationship with changes in BMI and waist-to-hip ratio in the GB group and had a near significant positive correlation with FBS in the SG group.Discussion. Neither GB nor SG modifies plasma levels of plasma fetuin-A or LECT-2 in T2D patients after surgery. The changes in plasma fetuin-A have a positive correlation with those of the BMI and waist-to-hip ratio 12 months after GB.

Published
2017

42. Genome-wide scan for circulating vascular adhesion protein-1 levels: MACROD2 as a potential transcriptional regulator of adipogenesis

Author

Chang, Yi-Cheng, primary, Hee, Siow-Wey, additional, Lee, Wei-Jei, additional, Li, Hung-Yuan, additional, Chang, Tien-Jyun, additional, Lin, Ming-Wei, additional, Hung, Yi-Jen, additional, Lee, I-Te, additional, Hung, Kuan-Yi, additional, Assimes, Themistocles, additional, Knowles, Joshua W, additional, Nong, Jiun-Yi, additional, Lee, Po-Chu, additional, Chiu, Yen-Feng, additional, and Chuang, Lee-Ming, additional

Published
2018
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46. Genome-wide linkage analysis and regional fine mapping identified variants in the RYR3 gene as a novel quantitative trait locus for circulating adiponectin in Chinese population

Author

Chang, Yi-Cheng, primary, Chiu, Yen-Feng, additional, He, Chih-Tsueng, additional, Sheu, Wayne Huey-Herng, additional, Lin, Ming-Wei, additional, Seto, Todd B., additional, Assimes, Themistocles, additional, Jou, Yuh-Shan, additional, Su, Lynn, additional, Lee, Wei-Jei, additional, Lee, Po-Chu, additional, Tsai, Shu-Huei, additional, and Chuang, Lee-Ming, additional

Published
2016
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47. Durability of Addition of Roux-en-Y Gastric Bypass to Lifestyle Intervention and Medical Management in Achieving Primary Treatment Goals for Uncontrolled Type 2 Diabetes in Mild to Moderate Obesity: A Randomized Control Trial

Author

Ikramuddin, Sayeed, primary, Korner, Judith, additional, Lee, Wei-Jei, additional, Bantle, John P., additional, Thomas, Avis J., additional, Connett, John E., additional, Leslie, Daniel B., additional, Inabnet, William B., additional, Wang, Qi, additional, Jeffery, Robert W., additional, Chong, Keong, additional, Chuang, Lee-Ming, additional, Jensen, Michael D., additional, Vella, Adrian, additional, Ahmed, Leaque, additional, Belani, Kumar, additional, Olofson, Amy E., additional, Bainbridge, Heather A., additional, and Billington, Charles J., additional

Published
2016
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49. Insulin secretion and interleukin-1β dependent mechanisms in human diabetes remission after metabolic surgery

Author

CHEN, Chih-Yen, LEE, Wei-Jei, ASAKAWA, Akihiro, FUJITSUKA, Naoki, CHONG, Keong, CHEN, Shu-Chun, LEE, Shou-Dong, and INUI, Akio

Subjects
Adult, Male, insulin secretion, interleukin-1β, Interleukin-1beta, Gastric Bypass, Glucose Tolerance Test, Middle Aged, Cardiovascular risk, Adipokines, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Gastrectomy, Risk Factors, glucose homeostasis, Cytokines, Humans, Insulin, Female, Prospective Studies, gastric bypass, sleeve gastrectomy
Abstract

To compare endocrine, metabolic, and inflammatory changes induced by gastric bypass (GB) and sleeve gastrectomy (SG) in patients with type 2 diabetes mellitus (T2DM), and to investigate the mechanisms of success after metabolic surgery. Sixteen GB and 16 SG patients were followed up before and at 1 year after surgery. The 75-g oral glucose tolerance test (OGTT) was performed before and after surgery. Glucose homeostasis, serum interleukin-1β, plasma gut hormones and adipokines, and the United Kingdom Prospective Diabetes Study (UKPDS) ten-year cardiovascular risks were evaluated. The diabetes remission rate was significantly higher in GB than SG. Changes in the area under the curve (AUC) for glucose were greater in those with complete and partial remission after GB and remitters after SG than non-remitters after SG, whereas changes in AUC for C-peptide were higher in complete and partial remitters after GB than non-remitters after SG. Insulinogenic index was enhanced and serum interleukin-1β was reduced in complete remitters after GB and remitters after SG. Logistic regression analysis confirmed that insulinogenic index and interleukin-1β, not insulin resistance, were the factors determining the success of diabetes remission after metabolic surgeries. GB and SG significantly reduced the ten-year risk of coronary heart disease and fatal coronary heart disease in T2DM patients after surgery, while GB had the additional benefit of reduced stroke risk. Human diabetes remission after metabolic surgery is through insulin secretion and interleukin-1β dependent mechanisms. GB is superior to SG in cardiocerebral risk reduction in Asian non-morbidly obese, not well-controlled T2DM patients.

Published
2013

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