Department of Endocrinology and Metabolism, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China.
Int J Endocrinol. 2013;2013:240971. doi: 10.1155/2013/240971. Epub 2013 Apr 17.
Aims. Although altered endocrine changes following bariatric surgery in morbidly obese patients with diabetes have been demonstrated by previous studies, little is known about their effects on low BMI patients of T2DM. We investigated the changes in adipokines and sICAM-1 in Chinese subjects with low BMI and T2DM after LRYGB and explored their relationship with postsurgical insulin sensitivity. Methods. Plasma levels of adiponectin, sICAM-1, fasting glucose, glycated hemoglobin, and fasting insulin and serum levels of visfatin were measured before and at three months after LRYGB in 33 T2DM patients with BMI of 22-30 kg·m(-2). Results. Significant reductions in anthropometric measurements and indicators of glucose and lipid metabolism and moderate reductions in insulin resistance and fasting insulin were observed at three months after LRYGB. Postoperative adiponectin level (P < 0.001) was increased compared to the preoperative level, whereas visfatin (P < 0.001) and sICAM-1 (P < 0.001) were lower than that before surgery. Serum adiponectin negatively correlated with HOMA-IR and FIns both preoperatively and at three months after surgery, and visfatin positively correlated with HOMA-IR and FIns both preoperatively and postoperatively. Conclusion. Changes in adipokines were related to an improvement in postsurgical insulin sensitivity, which was predicted by weight loss after LRYGB even in low BMI patients with T2DM.
目的。虽然之前的研究已经证明了病态肥胖伴糖尿病患者在接受减重手术后内分泌发生改变，但对于低 BMI 的 T2DM 患者，其对这些变化的影响还知之甚少。我们研究了中国低 BMI 的 T2DM 患者在接受 LRYGB 手术后脂联素和 sICAM-1 的变化，并探讨了它们与术后胰岛素敏感性的关系。方法。33 例 BMI 为 22-30kg·m(-2)的 T2DM 患者，在 LRYGB 术前和术后 3 个月时，分别检测血浆脂联素、sICAM-1、空腹血糖、糖化血红蛋白、空腹胰岛素和血清内脏脂肪素水平。结果。LRYGB 术后 3 个月，体重、血糖和血脂代谢指标显著降低，胰岛素抵抗和空腹胰岛素中度降低。术后脂联素水平（P < 0.001）较术前升高，而内脏脂肪素（P < 0.001）和 sICAM-1（P < 0.001）则低于术前。术前和术后血清脂联素与 HOMA-IR 和 FIns 均呈负相关，内脏脂肪素与 HOMA-IR 和 FIns 均呈正相关。结论。脂联素的变化与术后胰岛素敏感性的改善有关，这一改善可由 LRYGB 术后体重减轻来预测，即使是在低 BMI 的 T2DM 患者中也是如此。
