title: High baseline C-reactive protein levels predict partial type 2 diabetes mellitus remission after biliopancreatic diversion.
abstract: OBJECTIVE
  Several studies demonstrated that surgery can improve inflammation parameters, such as C-reactive protein (CRP). Few biomarkers have been investigated to potentially predict type 2 diabetes mellitus (T2DM) remission. We aimed at determining whether pre-surgery serum CRP levels could predict T2DM remission after 3 years in patients undergoing bariatric surgery, especially biliopancreatic diversion (BPD).
  
  
  RESULTS
  This study was conducted from 2007 to 2009 at the Surgical Department of the University of Genoa, Italy. Forty-four patients with T2DM undergoing BPD (n = 38) or Roux-en-Y gastric bypass (n = 6) were enrolled. The primary endpoint was to evaluate whether pre-surgery CRP levels could predict T2DM partial remission at 3-year follow-up. Secondary endpoints were to assess whether glycaemic, lipid, and inflammatory parameters modified during the follow-up. At baseline, patients with T2DM ranged from overweight to morbid obesity, had mild dyslipidaemia, and a low-grade inflammation. Bariatric surgery improved body weight, lipid and glycaemic profile both at 1- and 3-year follow-up. Pre-surgery CRP levels progressively decreased at 1- and 3-year follow-up. Among inflammatory pre-surgery parameters, only high CRP levels were shown to predict T2DM partial remission after 3 years. Multivariate analysis confirmed the predictive value of pre-surgery CRP levels independently of age, gender, type of surgery, and body mass index.
  
  
  CONCLUSIONS
  Bariatric surgery, in particular BPD, improved both metabolic and inflammatory biomarkers at 1- and 3-year follow-up. Pre-surgery high CRP levels predicted 3-year T2DM partial remission, indicating a promising target population to be especially treated with BPD.
authors.affiliation: First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy. Electronic address: aldobon85@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Bonaventura
authors.affiliation: First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Liberale
authors.affiliation: First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Carbone
authors.affiliation: International Federation of Surgery for Obesity, Genoa, Italy; Department of Surgery, University of Genoa, IRCCS AOU San Martino - IST, 10 Largo Benzi, 16132 Genoa, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Scopinaro
authors.affiliation: Department of Surgery, University of Genoa, IRCCS AOU San Martino - IST, 10 Largo Benzi, 16132 Genoa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Camerini
authors.affiliation: Department of Surgery, University of Genoa, IRCCS AOU San Martino - IST, 10 Largo Benzi, 16132 Genoa, Italy.
authors.forename: F S
authors.initials: FS
authors.lastname: Papadia
authors.affiliation: Diabetology Unit, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Cordera
authors.affiliation: First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; IRCCS AOU San Martino - IST, 10 Largo Benzi, 16132 Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Dallegri
authors.affiliation: International Federation of Surgery for Obesity, Genoa, Italy; Department of Surgery, University of Genoa, IRCCS AOU San Martino - IST, 10 Largo Benzi, 16132 Genoa, Italy.
authors.forename: G F
authors.initials: GF
authors.lastname: Adami
authors.affiliation: First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; IRCCS AOU San Martino - IST, 10 Largo Benzi, 16132 Genoa, Italy; Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 viale Benedetto XV, 16132 Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Montecucco
mesh_terms: D015904:Biliopancreatic Diversion; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007558:Italy; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012074:Remission Induction; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D018836:Inflammation Mediators; D008055:Lipids; D002097:C-Reactive Protein
keywords: Bariatric surgery; C-reactive protein; Glycaemic control; Inflammation; Type 2 diabetes