title: Tissue specificity in fasting glucose utilization in slightly obese diabetic patients submitted to bariatric surgery.
abstract: OBJECTIVE
  The present study was planned to investigate, by means of quantitative FDG-PET, how bariatric surgery (BS) modifies the metabolic pattern of the whole body and different tissues in slightly obese patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Before, 1 and 4 months after BS, 21 consecutive slightly obese T2DM patients underwent blood sampling to estimate plasma levels of glucose, insulin, glycosylated hemoglobin. At the same time points, these patients underwent a dynamic (18) F-FDG PET study of thorax and upper abdomen in fasting state and after washout of T2DM therapy. Gjedde-Patlak analysis was applied to estimate glucose uptake in the whole body and in different tissues (myocardium, skeletal back muscle, adipose tissue, and liver).
  
  
  RESULTS
  Surgical intervention quickly lowered levels of both insulin and glucose documenting an amelioration of glucose tolerance. Similarly, skeletal muscle and myocardial glucose uptake significantly increased soon after surgery (P < 0.001 and P < 0.01 at 1 month versus baseline, respectively) and remained substantially stable thereafter. By contrast, glucose uptake slightly decreased from its baseline values in the liver (P < 0.01 at 4 months) while no response could be documented over time in the adipose tissue.
  
  
  CONCLUSIONS
  These findings document that BS-induced modification of glucose homeostasis in slightly obese T2DM patients is mostly due to an increase in muscle glucose consumption. The surgically modified metabolic pattern of these patients might be of interest as a new model to investigate mechanism underlying insulin resistance.
authors: Nuclear Medicine Unit, Department Internal Medicine, University of Genoa, Genoa, Italy. silviadaniela.morbelli@hsanmartino.it
authors: Silvia
authors: S
authors: Morbelli
authors: Cecilia
authors: C
authors: Marini
authors: Gian Franco
authors: GF
authors: Adami
authors: Nobuyuki
authors: N
authors: Kudomi
authors: Giovanni
authors: G
authors: Camerini
authors: Patricia
authors: P
authors: Iozzo
authors: Michela
authors: M
authors: Massollo
authors: Selene
authors: S
authors: Capitanio
authors: Samanta
authors: S
authors: Bodrato
authors: Maria Teresa
authors: MT
authors: Verardi
authors: Francesco
authors: F
authors: Papadia
authors: Renzo
authors: R
authors: Cordera
authors: Juhani
authors: J
authors: Knuuti
authors: Nicola
authors: N
authors: Scopinaro
authors: Gianmario
authors: G
authors: Sambuceti
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism* / Q000601:surgery; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016014:Linear Models; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000601:surgery; D009928:Organ Specificity
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin