Epicardial and Pericardial Fat in Type 2 Diabetes: Favourable Effects of Biliopancreatic Diversion

Author(s):Show less -

Junqueira Vasques, Ana Carolina ^{[1, 2]} ; Pareja, Jose Carlos ^{[1, 3]} ; Mattos Souza, Jose Roberto ^[4] ; Yamanaka, Ademar ^[1] ; de Oliveira, Maria da Saude ^[1] ; Novaes, Fernanda Satake ^[1] ; Chaim, Elinton Adami ^[3] ; Piccinini, Francesca ^[5] ; Dalla Man, Chiara ^[5] ; Cobelli, Claudio ^[5] ; Geloneze, Bruno ^[1]

Affiliation

^[1] Univ Estadual Campinas, Lab Invest Metab & Diabet LIMED, Fac Med Sci, Gastroctr, UNICAMP, BR-13081970 Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Sch Appl Sci FCA, UNICAMP, Sao Paulo - Brazil

^[3] Univ Estadual Campinas, UNICAMP, Dept Surg, Diabet Surg Unit, Sao Paulo - Brazil

^[4] Univ Estadual Campinas, UNICAMP, Fac Med Sci, Dept Cardiol, Sao Paulo - Brazil

^[5] Univ Padua, Dept Informat Engn, Padua - Italy

• Document type: Journal article
• Source: OBESITY SURGERY; v. 25, n. 3, p. 477-485, MAR 2015.
• Web of Science Citations: 4

Abstract

Purpose Ectopic fat is often identified in obese subjects who are susceptible to the development of type 2 diabetes mellitus (T2DM). The ectopic fat favours the decrease in insulin sensitivity (IS) and adiponectin levels. We aimed to evaluate the effect of biliopancreatic diversion (BPD) on the accumulation of ectopic fat, adiponectin levels and IS in obese with T2DM. Materials and Methods A nonrandomised controlled study was performed on sixty-eight women: 19 lean-control (23.0 +/- 2.2 kg/m(2)) and 18 obese-control (35.0 +/- 4.8 kg/m(2)) with normal glucose tolerance and 31 obese with T2DM (36.3 +/- 3.7 kg/m(2) ). Of the 31 diabetic women, 20 underwent BPD and were reassessed 1 month and 12 months after surgery. The subcutaneous adipose tissue, visceral adipose tissue, epicardial adipose tissue and pericardial adipose tissue were evaluated by ultrasonography. The IS was assessed by a hyperglycaemic clamp, applying the minimal model of glucose. Results One month after surgery, there was a reduction in visceral and subcutaneous adipose tissues, whereas epicardial and pericardial adipose tissues exhibited significant reduction at the 12-month assessment (p<0.01). Adiponectin levels and IS were normalised 1 month after surgery, resembling lean-control values and elevated above the obese-control values (p<0.01). After 12 months, the improvement in IS and adiponectin was maintained, and 17 of the 20 operated patients exhibited fasting glucose and glycated haemoglobin within the normal range. Conclusions After BPD, positive physiological adaptations occurred in grade I and II obese patients with T2DM. These adaptations relate to the restoration of IS and decreased adiposopathy and explain the acute (1 month) and chronic (12 months) improvements in the glycaemic control. (AU)

• FAPESP's process: 08/09451-7 - Insulin secretory capacity in healthy patients, in obese, in obese type 2 diabetes and in obese type 2 diabetes undergoing bariatric surgery through the hyperglycemic clamp.
• Grantee: Bruno Geloneze Neto
• Support Opportunities: Regular Research Grants
• FAPESP's process: 08/07312-0 - Insulin secretory capacity in healthy patients, in obese, in obese type 2 diabetes and in obese type 2 diabetes undergoing bariatric surgery through the hyperglycemic clamp
• Grantee: Ana Carolina Junqueira Vasques
• Support Opportunities: Scholarships in Brazil - Doctorate