The effects of bariatric surgery on pancreatic lipid metabolism and blood flow.
BACKGROUND
Bariatric surgery leads to a rapid and sustained weight loss often accompanied with improvement in glucose homeostasis.


OBJECTIVE
The objective of this study was to investigate the effects of bariatric surgery on pancreatic lipid metabolism, blood flow, and glycemic control.


METHODS
This was a longitudinal study.


METHODS
The study was conducted in a clinical research center.


METHODS
This study included 27 morbidly obese and 15 healthy control subjects.


METHODS
Measurements were performed using positron emission tomography with the palmitate analog 14(R,S)-[(18)F]fluoro-6-thia-heptadecanoic acid and radiowater ([(15)O]H2O) and computed tomography. In morbidly obese subjects, positron emission tomography/computed tomography imaging studies were performed before and 6 months after bariatric surgery (either Roux-en-Y gastric bypass or sleeve gastrectomy).


METHODS
Pancreatic fat and fat-free volume, fatty acid uptake and blood flow were measured as well as parameters of β-cell function, glucose tolerance, and insulin sensitivity.


RESULTS
Six months after bariatric surgery, 23% excess weight loss was observed (P < .0001), and diabetes remission was seen in 7 of 10 patients. When compared with preoperative values, after surgery, notable decreases in pancreatic fat volume (P < .01), fatty acid uptake, and blood flow (both P < .05) were seen, whereas no change was seen in pancreatic fat-free volume. The decrease in pancreatic fat volume and the preservation of blood flow were associated with favorable glucose homeostasis and β-cell function.


CONCLUSIONS
Bariatric surgery elicits marked alterations in pancreatic lipid metabolism and blood flow, which may contribute to the observed improvement in glucose homeostasis and remission of type 2 diabetes.
Turku PET Centre (H.H., J.K., J.C.H., J.J.T., H.K.K., H.I., V.O., T.T., P.N.), University of Turku, 20520 Turku, Finland; Department of Endocrinology (M.S., P.N.) and Division of Digestive Surgery and Urology (P.S.), Turku University Hospital, 20520 Turku, Finland; Faculty of Medicine (N.K.), Kagawa University, Kagawa 760-0016, Japan; Institute of Biomedical Engineering (A.M.), National Research Council, 35127 Padua, Italy; and Institute of Clinical Physiology (P.I.), National Research Council, 56124 Pisa, Italy.
Henri
H
Honka
Jukka
J
Koffert
Jarna C
JC
Hannukainen
Jetro J
JJ
Tuulari
Henry K
HK
Karlsson
Heidi
H
Immonen
Vesa
V
Oikonen
Tuula
T
Tolvanen
Minna
M
Soinio
Paulina
P
Salminen
Nobu
N
Kudomi
Andrea
A
Mari
Patricia
P
Iozzo
Pirjo
P
Nuutila
D000328:Adult; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D050356:Lipid Metabolism / Q000502:physiology*; D008137:Longitudinal Studies; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery*; D010179:Pancreas / Q000098:blood supply* / Q000378:metabolism*; D012039:Regional Blood Flow / Q000502:physiology*; D016896:Treatment Outcome
D001786:Blood Glucose