Adipocyte size threshold matters: link with risk of type 2 diabetes and improved insulin resistance after gastric bypass.
BACKGROUND
Adipocyte volume has been associated with insulin resistance and type 2 diabetes.


OBJECTIVE
Our purpose was to identify an adipocyte volume threshold linked with increased insulin resistance risk, and to examine its association with insulin resistance improvement after bariatric surgery.


METHODS
We investigated two cohorts of Caucasian women, candidates for bariatric surgery, from two institutional centers in France (age 42.0 ± 11.5 years; body mass index, 47.6 ± 6.9 kg/m(2)) and Germany (age 41.3 ± 11.2 years; body mass index, 49.5 ± 8.1 kg/m(2)). 38% of the subjects had gastric bypass surgery and were followed for 6 months after the intervention. We defined a group of subjects with type 2 diabetes or at risk of type 2 diabetes (DRD) and investigated the relations between adipocyte volume and this status before and after surgery.


RESULTS
In both cohorts, subjects with DRD presented enlarged adipocytes (France, P = 3×10(-4); Germany, P =3×10(-10)) and we were able to determine thresholds in each cohort above which diabetes risk was potentially increased (France: 1003±42 pL, Germany: 798±32 pL). Subjects above those adipocyte thresholds were less prone to disappearance of the DRD status after bypass surgery (France, risk ratio = 2.1, P = .024; Germany, risk ratio = 1.3, P = .05).


CONCLUSIONS
We show in two cohorts of morbidly obese subjects that a specific adipocyte volume threshold may predict an increased risk for obesity-associated type 2 diabetes. However, this threshold might be established for each specific investigation site. Having a high adipocyte size is associated with a lower improvement of insulin resistance after bypass surgery in both cohorts.
Sorbonne Universities (A.C., C.P., K.C.), University Pierre et Marie Curie-Paris 6, UMR_S U1166, Nutriomics, F-75013 Paris, France; Institute of Cardiometabolism and Nutrition, ICAN, AP-HP (A.C., C.P., C.G., K.C.), Pitié-Salpêtrière hospital, F-75013 Paris, France; INSERM, UMR_S U1166 (A.C., C.P., K.C.), Nutriomics, F-75013 Paris, France; Assistance Publique-Hôpitaux de Paris (A.T.), Pitié-Salpêtrière hospital, Surgery Department, F-75013 Paris, France; Assistance Publique-Hôpitaux de Paris (J.-L.B.), Ambroise Paré Hospital, Surgery Department, F-92012 Boulogne-Billancourt, France; Department of Surgery (A.D.), University of Leipzig, 04003-04357 Leipzig, Germany; Department of Medicine (N.K., M.B.), University of Leipzig, 04003-04357 Leipzig, Germany; and Junior Research Group Animal Models (N.K.), IFB Obesity Diseases, University of Leipzig, 04003-04357 Leipzig, Germany; AdipoPhyt (K.L.), F-75013 Paris, France.
Aurelie
A
Cotillard
Christine
C
Poitou
Adriana
A
Torcivia
Jean-Luc
JL
Bouillot
Arne
A
Dietrich
Nora
N
Klöting
Cécile
C
Grégoire
Karine
K
Lolmede
Matthias
M
Blüher
Karine
K
Clément
D017667:Adipocytes / Q000473:pathology*; D000328:Adult; D048429:Cell Size; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D015390:Gastric Bypass; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D009767:Obesity, Morbid / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D012307:Risk Factors