title: Biliopancreatic Diversion Decreases Postprandial Apolipoprotein A-IV Levels in Mildly Obese Individuals with Type 2 Diabetes Mellitus: a Prospective Study.
abstract: Bariatric surgery usually leads to improvement on the general lipid profile, but its role in the levels of apolipoprotein A-IV (Apo-AIV) is not completely understood. Apo-AIV is a gut-released lipoprotein which is enrolled in satiety regulation and presents anti-inflammatory, anti-atherogenic, and anti-oxidative properties. The objective of this study was to determine the influence of biliopancreatic diversion (BPD) in the levels of Apo-AIV.
  
  
  
  This is a prospective exploratory study which evaluated eight obese individuals with type 2 diabetes mellitus (T2DM) who underwent BPD (Scopinaro operation) and were followed-up for 12 months. Apo-AIV levels were determined by means of serial dosages through a standard meal tolerance test (MTT) in the immediate preoperative period and then 12 months later.
  
  
  
  There was a significant change in the Apo-AIV curve following MTT before and after surgery. At 0 and 45 min, the Apo-AIV levels did not significantly differ before and after surgery; at 120 and 180 min, Apo-AIV levels were significantly lower following BPD.
  
  
  
  We observed a decrease of postprandial levels of Apo-AIV following MTT in mildly obese individuals with T2DM. This finding appears to be related to the suppression in the Apo-AIV response that obese individuals tend to present. Weight reduction itself, endotoxemia, and the large segments of bypassed intestine may be enrolled in this impaired response.
authors.affiliation: Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz; CEP 13085-000, Campinas, SP, Brazil. notrevezzo@yahoo.com.br.
authors.forename: Everton
authors.identifier: 0000-0002-5804-1580
authors.initials: E
authors.lastname: Cazzo
authors.affiliation: Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz; CEP 13085-000, Campinas, SP, Brazil.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Pareja
authors.affiliation: Research Laboratory of Metabolism and Diabetes (LIMED), Gastrocentro, State University of Campinas (UNICAMP), Campinas, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Geloneze
authors.affiliation: Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz; CEP 13085-000, Campinas, SP, Brazil.
authors.forename: Elinton Adami
authors.initials: EA
authors.lastname: Chaim
authors.affiliation: Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz; CEP 13085-000, Campinas, SP, Brazil.
authors.forename: Maria Rita Lazzarini
authors.initials: MR
authors.lastname: Barreto
authors.affiliation: Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz; CEP 13085-000, Campinas, SP, Brazil.
authors.forename: Daniéla Oliveira
authors.initials: DO
authors.lastname: Magro
mesh_terms: D000328:Adult; D001054:Apolipoproteins A / Q000097:blood*; D015904:Biliopancreatic Diversion; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery*; D019518:Postprandial Period / Q000502:physiology; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D001054:Apolipoproteins A; C022205:apolipoprotein A-IV
keywords: Apolipoprotein A-IV; Bariatric surgery; Biliopancreatic diversion; Lipoproteins, HDL; Obesity