title: Differential influences of gastric bypass and sleeve gastrectomy on plasma nesfatin-1 and obestatin levels in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  The mechanisms by which bariatric surgeries, including gastric bypass (GB) and sleeve gastrectomy (SG), achieve remission of type 2 diabetes mellitus (T2DM) and sustained weight reduction are unknown. We hypothesized that the novel anorexic hormone nesfatin-1 and another new hormone obestatin might contribute to the marked improvement in glycemic homeostasis and weight loss in diabetics after GB and SG.
  
  
  METHODS
  A hospital-based, prospective study was conducted. Overnight fasting plasma concentrations of nesfatin-1 and obestatin were analyzed in T2DM patients before surgery, and at 3 and 12 months after laparoscopic GB (n =12) and SG (n = 6).
  
  
  RESULTS
  At 12 months, reductions of body mass index (BMI), fasting blood glucose, and glycated hemoglobin were similar between GB and SG groups (P all > 0.05). Plasma nesfatin-1 levels in patients undergoing GB or SG significantly decreased after surgeries (P both < 0.05). In contrast, plasma obestatin concentrations significantly increased in patients after SG (P < 0.05) but without any alteration after GB. The alterations of plasma nesfatin-1 were significantly and negatively associated with the reduction of fasting blood glucose (P <0.05) at 12 months after GB and SG. In the SG group, the reduction of nesfatin-1 significantly and positively correlated with the decrease of BMI (P < 0.05).
  
  
  CONCLUSIONS
  GB and SG produce differential influences with regards to circulating nesfatin-1 and obestatin levels in non-morbidly obese, T2DM patients. Circulating nesfatin-1 may modulate glucose homeostasis in two surgical procedures, and participate in regulating body weight in SG.
authors.affiliation: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
authors.forename: Wei-Jei
authors.initials: WJ
authors.lastname: Lee
authors.forename: Chih-Yen
authors.initials: CY
authors.lastname: Chen
authors.forename: Kong-Han
authors.initials: KH
authors.lastname: Ser
authors.forename: Keong
authors.initials: K
authors.lastname: Chong
authors.forename: Shu-Chun
authors.initials: SC
authors.lastname: Chen
authors.forename: Pui-Ching
authors.initials: PC
authors.lastname: Lee
authors.forename: You-Di
authors.initials: YD
authors.lastname: Liao
authors.forename: Shou-Dong
authors.initials: SD
authors.lastname: Lee
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002135:Calcium-Binding Proteins / Q000097:blood*; D004268:DNA-Binding Proteins / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000097:blood*; D000080866:Nucleobindins; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D002135:Calcium-Binding Proteins; D004268:DNA-Binding Proteins; D054439:Ghrelin; C000630650:NUCB2 protein, human; D009419:Nerve Tissue Proteins; D000080866:Nucleobindins; C505799:obestatin, human