Yang Po-Jen, Ser Kong-Han, Lin Ming-Tsan, Nien Hsiao-Ching, Chen Chiung-Nien, Yang Wei-Shiung, Lee Wei-Jei
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Surgery, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.
Obes Surg. 2015 Dec;25(12):2328-34. doi: 10.1007/s11695-015-1688-5.
Recent studies showed that fetuin-A and matrix metalloproteinase-7 (MMP-7) are type 2 diabetes mellitus (T2DM)-associated markers. Bariatric surgery not only reduces body weight but also improves T2DM. This study aimed to investigate the changes of fetuin-A and MMP-7 in obese subjects with and without T2DM after bariatric surgery.
We enrolled 130 obese subjects that received bariatric surgery, including 41 Roux-en-Y gastric bypass (RYGB), 67 mini-gastric bypass (MGB), and 22 sleeve gastrectomy (SG) patients. Forty-three patients suffered from T2DM prior to surgery. The fasting serum fetuin-A and MMP-7 levels were measured before and 1 year after surgery.
Only five of 43 patients remained diabetic after surgery. Preoperative T2DM patients had higher fetuin-A and MMP-7 levels than non-T2DM subjects. RYGB, MGB, and SG all decreased the fetuin-A levels 1 year after the operation. The MMP-7 levels were not changed after RYGB, MGB, or SG. In multivariate analyses, the preoperative fetuin-A was significantly related to the diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c), while the postoperative fetuin-A was independently related to the waist-to-hip ratio and HbA1c. Moreover, the preoperative MMP-7 level was significantly related to age, DBP, aspartate transaminase, alanine transaminase, and gamma-glutamyl transferase (rGT), while the postoperative MMP-7 level was independently related to age and rGT.
The fetuin-A and MMP-7 levels are both higher in obese T2DM than non-T2DM subjects. The level of fetuin-A is reduced after RYGB, MGB, and SG, but the level of MMP-7 remains unchanged.
近期研究表明，胎球蛋白-A和基质金属蛋白酶-7（MMP-7）是2型糖尿病（T2DM）相关标志物。减重手术不仅能减轻体重，还能改善T2DM。本研究旨在调查减重手术后有或无T2DM的肥胖受试者中胎球蛋白-A和MMP-7的变化。
我们纳入了130例接受减重手术的肥胖受试者，包括41例行Roux-en-Y胃旁路术（RYGB）、67例行迷你胃旁路术（MGB）和22例行袖状胃切除术（SG）的患者。43例患者术前患有T2DM。在手术前和术后1年测量空腹血清胎球蛋白-A和MMP-7水平。
43例患者中术后仅有5例仍患有糖尿病。术前T2DM患者的胎球蛋白-A和MMP-7水平高于非T2DM受试者。RYGB、MGB和SG术后1年均降低了胎球蛋白-A水平。RYGB、MGB或SG术后MMP-7水平未发生变化。在多因素分析中，术前胎球蛋白-A与舒张压（DBP）和糖化血红蛋白（HbA1c）显著相关，而术后胎球蛋白-A与腰臀比和HbA1c独立相关。此外，术前MMP-7水平与年龄、DBP、天冬氨酸转氨酶、丙氨酸转氨酶和γ-谷氨酰转移酶（rGT）显著相关，而术后MMP-7水平与年龄和rGT独立相关。
肥胖T2DM患者的胎球蛋白-A和MMP-7水平均高于非T2DM受试者。RYGB、MGB和SG术后胎球蛋白-A水平降低，但MMP-7水平保持不变。
