Diabetes Associated Markers After Bariatric Surgery: Fetuin-A, but Not Matrix Metalloproteinase-7, Is Reduced.
BACKGROUND
Recent studies showed that fetuin-A and matrix metalloproteinase-7 (MMP-7) are type 2 diabetes mellitus (T2DM)-associated markers. Bariatric surgery not only reduces body weight but also improves T2DM. This study aimed to investigate the changes of fetuin-A and MMP-7 in obese subjects with and without T2DM after bariatric surgery.


METHODS
We enrolled 130 obese subjects that received bariatric surgery, including 41 Roux-en-Y gastric bypass (RYGB), 67 mini-gastric bypass (MGB), and 22 sleeve gastrectomy (SG) patients. Forty-three patients suffered from T2DM prior to surgery. The fasting serum fetuin-A and MMP-7 levels were measured before and 1 year after surgery.


RESULTS
Only five of 43 patients remained diabetic after surgery. Preoperative T2DM patients had higher fetuin-A and MMP-7 levels than non-T2DM subjects. RYGB, MGB, and SG all decreased the fetuin-A levels 1 year after the operation. The MMP-7 levels were not changed after RYGB, MGB, or SG. In multivariate analyses, the preoperative fetuin-A was significantly related to the diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c), while the postoperative fetuin-A was independently related to the waist-to-hip ratio and HbA1c. Moreover, the preoperative MMP-7 level was significantly related to age, DBP, aspartate transaminase, alanine transaminase, and gamma-glutamyl transferase (rGT), while the postoperative MMP-7 level was independently related to age and rGT.


CONCLUSIONS
The fetuin-A and MMP-7 levels are both higher in obese T2DM than non-T2DM subjects. The level of fetuin-A is reduced after RYGB, MGB, and SG, but the level of MMP-7 remains unchanged.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. paulpjyang@yahoo.com.tw.|Department of Surgery, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan. paulpjyang@yahoo.com.tw.|Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. paulpjyang@yahoo.com.tw.
Po-Jen
PJ
Yang
Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan. maxist_ser@hotmail.com.
Kong-Han
KH
Ser
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. linmt@ntu.edu.tw.
Ming-Tsan
MT
Lin
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. celian0916@yahoo.com.tw.|Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan. celian0916@yahoo.com.tw.
Hsiao-Ching
HC
Nien
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. cnchen@ntu.edu.tw.
Chiung-Nien
CN
Chen
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. wsyang@ntu.edu.tw.|Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. wsyang@ntu.edu.tw.
Wei-Shiung
WS
Yang
Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan. wjlee_obessurg_tw@yahoo.com.tw.
Wei-Jei
WJ
Lee
D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000534:rehabilitation; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery*; D015536:Down-Regulation; D005215:Fasting / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006801:Humans; D008297:Male; D020783:Matrix Metalloproteinase 7 / Q000032:analysis / Q000097:blood*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D049629:Waist-Hip Ratio; D015431:Weight Loss; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis / Q000378:metabolism*
D015415:Biomarkers; D006442:Glycated Hemoglobin; D020783:Matrix Metalloproteinase 7; D060749:alpha-2-HS-Glycoprotein; C556354:AHSG protein, human; C060932:MMP7 protein, human
Bariatric surgery; Diabetes; Fetuin-A; MMP-7; Obesity