Seo Mihae, Kim Hyoungnae, Noh Hyunjin, Jeon Jin Seok, Byun Dong Won, Kim Sang Hyun, Kim Hye Jeong, Suh Kyoil, Park Hyeong Kyu, Kwon Soon Hyo
Internal Medicine, Soonchunhyang University Hospital, Gumi, Gyeongsangbuk-do, The Republic of Korea.
Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, The Republic of Korea.
BMJ Open Diabetes Res Care. 2020 Oct;8(1). doi: 10.1136/bmjdrc-2020-001372.
Recent studies have suggested that extracellular circulating and urinary mitochondrial DNA (mtDNA) are associated with mitochondrial dysfunction in obesity and type 2 diabetes mellitus (T2DM). However, the changes to cell-free serum and urinary mtDNA after bariatric surgery in patients with obesity with T2DM have not been investigated to date.
We prospectively recruited patients with obesity (n=18), and with obesity and T2DM (n=14) who underwent bariatric surgery, along with healthy volunteers (HV) as a control group (n=22). Serum and urinary mitochondrial nicotinamide adenine dinucleotide dehydrogenase subunit-1 (mtND-1) and cytochrome-c oxidase 3 (mtCOX-3) copy numbers were measured using quantitative PCR (qPCR). The mtDNA copy numbers of patients with obesity (with and without T2DM) were followed up 6 months after surgery.
The copy numbers of urinary mtND-1 and mtCOX-3 in patients with obesity, with or without T2DM, were higher than those in the HVs. Moreover, urinary mtCOX-3 copy number increased in patients with obesity with T2DM compared with patients with obesity without T2DM (p=0.018). Meanwhile, serum mtCOX-3 copy numbers in HV were higher in both obesity patient groups (p=0.040). Bariatric surgery reduced urinary mtND-1 and mtCOX-3 copy numbers, as well as serum mtCOX-3 copy numbers only in patients with obesity with T2DM.
These results suggest that T2DM induces greater kidney mitochondrial dysfunction in patients with obesity, which can be effectively restored with bariatric surgery.
最近的研究表明，细胞外循环和尿液中的线粒体DNA（mtDNA）与肥胖症和2型糖尿病（T2DM）中的线粒体功能障碍有关。然而，迄今为止，尚未对肥胖合并T2DM患者进行减肥手术后无细胞血清和尿液mtDNA的变化进行研究。
我们前瞻性招募了接受减肥手术的肥胖患者（n = 18）、肥胖合并T2DM患者（n = 14），并将健康志愿者（HV）作为对照组（n = 22）。使用定量PCR（qPCR）测量血清和尿液中的线粒体烟酰胺腺嘌呤二核苷酸脱氢酶亚基1（mtND-1）和细胞色素c氧化酶3（mtCOX-3）的拷贝数。对肥胖患者（有和没有T2DM）的mtDNA拷贝数在手术后6个月进行随访。
无论是否患有T2DM，肥胖患者尿液中mtND-1和mtCOX-3的拷贝数均高于健康志愿者。此外，与无T2DM的肥胖患者相比，患有T2DM的肥胖患者尿液中mtCOX-3拷贝数增加（p = 0.018）。同时，两个肥胖患者组中健康志愿者的血清mtCOX-3拷贝数均较高（p = 0.040）。减肥手术仅降低了肥胖合并T2DM患者的尿液mtND-1和mtCOX-3拷贝数以及血清mtCOX-3拷贝数。
这些结果表明，T2DM在肥胖患者中诱发了更严重的肾脏线粒体功能障碍，减肥手术可以有效恢复这种功能障碍。
