scholarly journals The impact of bariatric surgery on serum tryptophan–kynurenine pathway metabolites

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Kai Tai Derek Yeung ◽  
Nicholas Penney ◽  
Luke Whiley ◽  
Hutan Ashrafian ◽  
Matthew R. Lewis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Serum Levels ◽  
Kynurenine Pathway ◽  
Xanthurenic Acid ◽  
Liquid Chromatography Tandem Mass ◽  
Post Operation ◽  
Ultrahigh Performance Liquid Chromatography ◽  
The Impact

AbstractThis study aims to explore the immediate effects of bariatric surgery on serum tryptophan–kynurenine pathway metabolites in individuals with type 2 diabetes and BMI > 30. With the goal of providing insight into the link between tryptophan pathway metabolites, type 2 diabetes, and chronic obesity-induced inflammation. This longitudinal study included 20 participants. Half were diagnosed with type 2 diabetes. 11 and 9 underwent RYGB and SG respectively. Blood samples were obtained at pre-operative and 3 months post-operative timepoints. Tryptophan and downstream metabolites of the kynurenine pathway were quantified with an ultrahigh-performance liquid chromatography tandem mass spectrometry with electrospray ionisation method. At 3 months post-operation, RYGB led to significant reductions in tryptophan, kynurenic acid and xanthurenic acid levels when compared to baseline. Significant reductions of the same metabolites after surgery were also observed in individuals with T2D irrespective of surgical procedure. These metabolites were significantly correlated with serum HbA1c levels and BMI. Bariatric surgery, in particular RYGB reduces serum levels of tryptophan and its downstream kynurenine metabolites. These metabolites are associated with T2D and thought to be potentially mechanistic in the systemic processes of obesity induced inflammation leading to insulin resistance. Its reduction after surgery is associated with an improvement in glycaemic control (HbA1c).

scholarly journals The Impact of Bariatric Surgery on Serum Tryptophan-Kynurenine Pathway Metabolites

2021 ◽  
Author(s):  
Kai Tai Derek Yeung ◽  
Nicholas Penney ◽  
Luke Whiley ◽  
Hutan Ashrafian ◽  
Matthew R Lewis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Serum Levels ◽  
Kynurenine Pathway ◽  
Xanthurenic Acid ◽  
Liquid Chromatography Tandem Mass ◽  
Post Operation ◽  
Ultrahigh Performance Liquid Chromatography ◽  
The Impact

Abstract Objectives This study aims to explore the immediate effects of bariatric surgery on serum tryptophan – kynurenine pathway metabolites in individuals with type 2 diabetes and BMI > 30. With the goal of providing insight into the link between tryptophan pathway metabolites, type 2 diabetes, and chronic obesity-induced inflammation.Methods This longitudinal study included 20 participants. Half were diagnosed with type 2 diabetes. 11 and 9 underwent RYGB and SG respectively. Blood samples were obtained at pre-operative and three months post-operative timepoints. Tryptophan and downstream metabolites of the kynurenine pathway were quantified with an ultrahigh-performance liquid chromatography tandem mass spectrometry with electrospray ionisation method.Results At 3 months post-operation, RYGB led to significant reductions in tryptophan, kynurenic acid and xanthurenic acid levels when compared to baseline. Significant reductions of the same metabolites after surgery were also observed in individuals with T2D irrespective of surgical procedure. These metabolites were significantly correlated with serum HbA1c levels.Conclusions Bariatric surgery, in particular RYGB reduces serum levels of tryptophan and its downstream kynurenine metabolites. These metabolites are associated with T2D and thought to be potentially mechanistic in systemic processes leading to insulin resistance. Its reduction after surgery is associated with an improvement in glycaemic control (HbA1c).

The Impact of Bariatric Surgery in Patients with Type-2 Diabetes Mellitus

2011 ◽  
Vol 7 (3) ◽  
pp. 185-189 ◽  
Author(s):  
Richdeep S. Gill ◽  
Arya M. Sharma ◽  
David P. Al-Adra ◽  
Daniel W. Birch ◽  
Shahzeer Karmali
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Type 2 Diabetes Mellitus ◽  
The Impact

scholarly journals Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in Slovenia

2011 ◽  
Vol 14 (1) ◽  
pp. 3-9 ◽  
Author(s):  
S Kariž ◽  
D Petrovič
Keyword(s):  
Myocardial Infarction ◽  
Type 2 Diabetes ◽  
Gene Polymorphisms ◽  
Serum Levels ◽  
Control Group ◽  
Interleukin 18 ◽  
Significant Difference ◽  
Promoter Gene ◽  
The Impact

Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in SloveniaType 2 diabetes is a major risk factor for myocardial infarction (MI) and chronic inflammation may play a central role in both diseases. Interleukin (IL)-18 is a potent proinflammatory cytokine, which is considered important in acute coronary syndromes and type 2 diabetes. We investigated the association of the -137 (G>C), polymorphism (rs187238) and the -607 (C<A) polymorphism (rs1946518) of the IL-18 gene promoter region in 495 Caucasians with type 2 diabetes, of whom 169 had MI and 326 subjects had no clinically evident coronary artery disease (controls). We also investigated the impact of these polymorphisms on the serum IL-18 level in subsets of both groups and in a normal group. Genotype distributions of the polymorphisms showed no significant difference between cases and controls. However, IL-18 serum levels were significantly lower in diabetics with the137 CC genotype than in those with other genotypes (241.5 ± 132.7 ng/Lvs.340.2 ± 167.4 ng/L; p <0.05). High sensitivity C-reactive protein and IL-18 serum levels were higher in diabetics in the MI group than in the control group. We conclude that these IL-18 promoter gene polymorphisms are not risk factors for MI in Caucasians with type 2 diabetes.

Sex-Dependent Effect of Metformin on Serum Prolactin Levels In Hyperprolactinemic Patients With Type 2 Diabetes: A Pilot Study

2017 ◽  
Vol 126 (06) ◽  
pp. 342-348 ◽  
Author(s):  
Robert Krysiak ◽  
Witold Szkróbka ◽  
Bogusław Okopień
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Sensitivity ◽  
Elevated Serum ◽  
Serum Levels ◽  
Pituitary Hormones ◽  
Serum Prolactin ◽  
Free Thyroid Hormones ◽  
The Impact ◽  
Circulating Levels

Abstract Background Metformin was found to reduce circulating levels of pituitary hormones. Objective The purpose of this study was to assess whether sex determines the effect of metformin on lactotroph secretory function. Methods The study population included 25 women and 12 men with mildly elevated serum prolactin levels (25–75 ng/mL). Because of concomitant type 2 diabetes, all participants were treated with metformin (3 g daily). Plasma levels of glucose and lipids, HOMA1-IR, serum levels of prolactin, thyrotropin and free thyroid hormones, as well as Jostel’s, SPINA-GT and SPINA-GD indices were assessed at baseline and at the end of metformin treatment. Results The study completed 24 women and 11 men. At baseline, there were no significant differences in circulating levels of glucose and lipids, insulin sensitivity, hormones, Jostel’s, SPINA-GT and SPINA-GD indices between women and men. In both men and women, metformin reduced fasting glucose levels and HOMA1-IR. However, only in women metformin decreased elevated prolactin levels and this effect correlated with an improvement insulin sensitivity, as well as with the impact on SPINA-GT. Conclusions The results of the study suggest that the effect of metformin on serum prolactin levels is sex-dependent.

scholarly journals Metabolic Effects of Bariatric Surgery

2018 ◽  
Vol 64 (1) ◽  
pp. 72-81 ◽  
Author(s):  
Piriyah Sinclair ◽  
Neil Docherty ◽  
Carel W le Roux
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Metabolic Surgery ◽  
Positive Impact ◽  
Metabolic Effects ◽  
Beneficial Effects ◽  
Treatment Of Obesity ◽  
The Impact ◽  
The Brain

Abstract BACKGROUND Obesity can be defined as a chronic subcortical brain disease, as there is an important neurophysiological component to its etiology based on changes in the functioning of those areas of the brain controlling food intake and reward. Extensive metabolic changes accompany bariatric surgery-based treatment of obesity. Consequently, the term “metabolic” surgery is being increasingly adopted in relation to the beneficial effects these procedures have on chronic diseases like type 2 diabetes. CONTENT In the present review, we focus on the key biochemical and physiological changes induced by metabolic surgery and highlight the beneficial effects accrued systemically with the use of an organ-based approach. Understanding the impact on and interactions between the gut, brain, adipose tissue, liver, muscle, pancreas, and kidney is key to understanding the sum of the metabolic effects of these operations. SUMMARY Further mechanistic studies are essential to assess the true potential of metabolic surgery to treat metabolic comorbidities of obesity beyond type 2 diabetes. Approaches that may mitigate the metabolic side effects of surgery also require attention. Understanding the positive impact of metabolic surgery on metabolic health may result in a wider acceptance of this intervention as treatment for metabolic, comorbid conditions.

scholarly journals The impact of bariatric surgery on incident microvascular complications in patients with type 2 diabetes: A matched controlled population-based retrospective cohort study

2020 ◽  
Author(s):  
Pushpa Singh ◽  
Nicola Adderley ◽  
Anuradhaa Subramanian ◽  
Krishna Gokhale ◽  
Rishi Singhal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Cohort Study ◽  
Microvascular Complications ◽  
Population Based ◽  
Type2 Diabetes ◽  
Foot Disease ◽  
The Impact ◽  
Surgical Group

Aim: To assess the impact of bariatric surgery (BS) on incident microvascular complications [diabetes-related foot disease (DFD), sight threatening diabetic retinopathy (STDR), chronic kidney disease (CKD)] in patients with type 2 diabetes and obesity. <p>Methods: <a>A retrospective matched, controlled population-based cohort study of adults with type 2 diabetes between 1/1/1990 and 31/1/2018 using </a><a>IQVIA Medical Research Data (IMRD), </a>a database of primary care electronic records. <a>Each patient with type2 diabetes who subsequently had BS (surgical) was matched on index date with up to 2 patients with type 2 diabetes did not have BS (non-surgical) within the same general practice by age, sex, pre-index body mass index and diabetes duration</a>.</p> <p>Results: 1126 surgical and 2219 non-surgical participants were included. In the study population, 2261 (68%) were women; Mean (SD) age was 49.87 (9.3) vs 50.12 (9.3) years and BMI was 46.76 (7.96) kg/m<sup>2</sup> vs 46.14 (7.49) kg/m<sup>2</sup> in surgical vs non-surgical group respectively. In surgical group, 22.1%, 22.7%, 52.2% and 1.1% patients had gastric band, sleeve gastrectomy, gastric bypass & duodenal switch respectively.</p> <p>Over median (IQR) follow-up was 3.9 years (1.8-6.4), BS was associated with reduction in incident combined microvascular complications (adjusted HR 0.63, 95% CI 0.51 to 0.78, p<0.001), DFD (0.61, 0.50 to 0.75, p<0.001), STDR (0.66, 0.44 to 1.00, p<0.001), CKD (0.63, 0.51 to 0.78, p<0.001). Analysis based on the type of surgery showed that all types of surgery were associated with favourable impact on the incident of composite microvascular complications, greatest reduction RYGB.</p> <p>Conclusions: BS was associated with a significant reduction in incident diabetes-related microvascular complications. </p>

The Impact of Type 2 Diabetes Mellitus on the Markers of Osteoporosis (Sclerostin and CTRP3) in Postmenopausal Women: A Comparative, Observational, Study

2020 ◽  
Author(s):  
Inass Hassan Ahmad ◽  
Mervat El Shahat El Wakeel ◽  
Sally Said Abd Elhamed ◽  
Marwa Abdelmonim Mohammed ◽  
Basma Elnagger ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Postmenopausal Women ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Diabetic Patients ◽  
Observation Study ◽  
Left Femur ◽  
The Impact

Abstract Background In the present study, our goal was to assess the impact of type 2 diabetes mellites (T2DM) on osteoporosis markers (sclerostin and CTRP3) among postmenopausal women, and whether sclerostin and CTRP3 can be used as early biomarkers of osteoporosis/osteopenia in T2DM patients. Methods In a comparative, observation, study, a total of 30 postmenopausal women with osteoporosis/osteopenia and T2DM were included, as well as 30 non-diabetic women with osteoporosis/osteopenia. Thirty age and sex-matched healthy women were included as control groups. The enzyme-linked immunosorbent assay (ELISA) was used to assess the serum levels of sclerostin and CTRP3. Results A total of 90 women were included in the present study (30 patients per group). The serum CTRP3 was significantly lower in the DM-OST (3.45 ± 3.5 ng/dL) and OST (9.15 ± 3.65 ng/dL) groups than the control group (16.80 ± 0.55 ng/dL; p < 0.001); likewise, the serum sclerostin was higher in the DM-OST (109.95 ± 28.96 pmol/L) and OST (51.52 ± 23.18 pmol/L) than the control group (11.22 ± 1.21 pmol/L; p < 0.001). Notably, the serum CTRP3 was significantly lower and sclerostin was significantly higher in the DM-OST group than the OST group (p < 0.001)). In the DM + OST and OST groups, the serum CTRP3 correlated positively with BMD of lumbar spines, left femur, and left forearm. Serum CTRP3 was associated with lower risk of osteoporosis (OR) and diabetes (OR) in postmenopausal women. In addition, the serum sclerostin was associated with higher risk of osteoporosis (OR) and diabetes (OR) in postmenopausal women. Conclusion The present study provides a novel evidence about the impact of T2DM on osteoporosis biomarkers, serum CTRP3 and sclerostin. The results indicated that women with combined T2DM and osteoporosis/osteopenia exhibited more dysregulation in both biomarkers than women with osteoporosis/osteopenia. alone. Thus, serum CTRP3 and sclerostin can be used as biomarkers for early detection of osteoporosis in diabetic patients.

scholarly journals Changes in Serum Levels of Bone Morphogenic Protein 4 and Inflammatory Cytokines after Bariatric Surgery in Severely Obese Korean Patients with Type 2 Diabetes

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Mee Kyoung Kim ◽  
Eun-Hee Jang ◽  
Oak-Kee Hong ◽  
Hyun-Ji Chun ◽  
Soon-Jib Yoo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Inflammatory Cytokines ◽  
High Sensitivity ◽  
Plasminogen Activator Inhibitor ◽  
Serum Levels ◽  
Diabetes Remission ◽  
Bone Morphogenic Protein ◽  
Pai 1

Serum bone morphogenic protein- (BMP-) 4 levels are associated with human adiposity. The aim of this study was to investigate changes in serum levels of BMP-4 and inflammatory cytokines after Roux-en-Y gastric bypass (RYGB). Fifty-seven patients with type 2 diabetes underwent RYGB. Serum levels of BMP-4 and various inflammatory markers, including high-sensitivity C-reactive protein (hsCRP), free fatty acids (FFAs), and plasminogen activator inhibitor- (PAI-) 1, were measured before and 12 months after RYGB. Remission was defined as glycated hemoglobin <6.5% for at least 1 year in the absence of medications. Levels of PAI-1, hsCRP, and FFAs were significantly decreased at 1 year after RYGB. BMP-4 levels were also significantly lower at 1 year after RYGB than at baseline (P=0.024). Of the 57 patients, 40 (70%) had diabetes remission at 1 year after surgery (remission group). Compared with patients in the nonremission group, patients in the remission group had lower PAI-1 levels and smaller visceral fat areas at baseline. There was a difference in the change in the BMP-4 level according to remission status. Our data demonstrate a significant beneficial effect of bariatric surgery on established cardiovascular risk factors and a reduction in chronic nonspecific inflammation after surgery.

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