Adipose tissue biomarkers involved in early resolution of type 2 diabetes after bariatric surgery.
BACKGROUND
Bariatric surgery improves glycemic metabolism, even before weight loss. However, this improvement in carbohydrate metabolism is not always sufficient for complete remission of type 2 diabetes (T2D). The previous inflammatory state of the adipose tissue may affect this improvement.


OBJECTIVE
We assessed whether the gene expression of inflammatory markers in visceral adipose tissue and subcutaneous adipose tissue (SAT) was associated with the short-term remission of T2D after bariatric surgery.


METHODS
Virgen de la Victoria Clinical Hospital and Regional University Hospital, both in Malaga, Spain.


METHODS
We analyzed the baseline mRNA expression of interleukin 6, tumor necrosis factor α (TNF-α), CD11 B, CD163, CD11 C, fatty acid synthase, B-cell CLL/lymphoma 2, caspase 3 (CASP3), and peroxisome proliferator-related receptor γ in 60 morbidly obese patients with T2D treated before bariatric surgery with metformin, classified according to whether they were still being treated with metformin 3 months after bariatric surgery (MO-T2D+) or not (MO-T2D-).


RESULTS
The MO-T2D- group reported higher interleukin 6, TNF-α, and CD11 B and lower CD163 baseline mRNA expression in SAT than the MO-T2D+group. Lower TNF-α, CD11 B, fatty acid synthase, and CASP3 and higher CD11 C mRNA expression was found in SAT than in visceral adipose tissue only in the MO-T2D+group. The baseline variable associated with the presence of T2D 3 months after bariatric surgery in a logistic regression model was the mRNA expression of TNF-α in SAT (B = -290.1, P = .017) (R2= .338).


CONCLUSIONS
This study reports for the first time, to our knowledge, that morbidly obese patients with T2D who still required metformin treatment 3 months after bariatric surgery had a lower level of inflammatory mRNA gene expression in SAT before bariatric surgery.
Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria/Universidad de Málaga, Malaga, Spain; CIBEROBN, Instituto de Salud Carlos III, Malaga, Spain. Electronic address: lourgarrido@gmail.com.
Lourdes
L
Garrido-Sánchez
Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria/Universidad de Málaga, Malaga, Spain.
Monica
M
Tomé
Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria/Universidad de Málaga, Malaga, Spain.
Concepcion
C
Santiago-Fernández
Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario, Malaga, Spain; CIBERDEM, Instituto de Salud Carlos III, Malaga, Spain.
Sara
S
García-Serrano
CIBEROBN, Instituto de Salud Carlos III, Malaga, Spain; Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario, Malaga, Spain. Electronic address: edugf1@gmail.com.
Eduardo
E
García-Fuentes
Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Clínico Virgen de la Victoria/Universidad de Málaga, Malaga, Spain; CIBEROBN, Instituto de Salud Carlos III, Malaga, Spain.
Francisco J
FJ
Tinahones
D015703:Antigens, CD / Q000378:metabolism; D050110:Bariatric Surgery; D015415:Biomarkers / Q000378:metabolism*; D053148:Caspase 3 / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery; D047495:PPAR gamma / Q000378:metabolism; D012333:RNA, Messenger; D050151:Subcutaneous Fat / Q000378:metabolism*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015703:Antigens, CD; D015415:Biomarkers; D007004:Hypoglycemic Agents; D047495:PPAR gamma; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D008687:Metformin; D053148:Caspase 3
Adipose tissue; Bariatric surgery; Inflammation; Morbid obesity; TNF-α; Type 2 diabetes mellitus