Endocrine Abstracts (2017) 50 P337 | DOI: 10.1530/endoabs.50.P337

Effect of Roux-en-Y bariatric surgery on lipoproteins, insulin resistance, and systemic and vascular inflammation in obese patients with and without diabetes

Shaishav Shashikant Dhage1, Safwaan Adam1, Jan Hoong Ho1, Rahul Yadav1, Salam Hama1, Jonathan Schofield2, Michael France2, Akheel A Syed3, Tarza Siahmansur1, Philip Pemberton2, Reza Aghamohammadzadeh1, Rachelle Donn1, Rayaz A Malik4, John P New3, Paul Durrington1, Basil A Ammori3, Yifen Liu1 & Handrean Soran1,2


1University Of Manchester, Manchester, UK; 2Central Manchester University Hospitals, Manchester, UK; 3Salford Royal hospital, Manchester, UK; 4Weill Cornell Medicine-Qatar, Doha, Qatar.


Background: Obesity is a major modifiable risk factor for cardiovascular disease. Bariatric surgery is considered to be the most effective treatment option for weight reduction in obese patients with and without type 2 diabetes.

Aims: To evaluate changes in lipoproteins, insulin resistance, mediators of systemic and vascular inflammation and endothelial dysfunction following Roux-en-Y bariatric surgery in obese patients with and without diabetes.

Methods: Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction were measured in 27 obese patients with (n=11) and without type 2 diabetes (n=16), before and, six and twelve months after Roux-en-Y bariatric surgery.

Results: There were significant reductions in body mass index, waist circumference, small dense LDL apoB, fasting glucose, HbA1c, insulin HOMA-IR, hsCRP, TNFα, IL-6, MCP-1, ICAM-1, E-selectin and leptin and a significant increase in adiponectin 6 months after surgery. HOMA-IR, resistin, MCP-1 and ICAM-1 were further significantly reduced at 12 months, only in the diabetic group.There is a positive correlation between the relative proportional reduction in change in insulin resistance and the proportional change in resistin levels and a positive correlation between the proportional change in BMI and proportional change in leptin.

Conclusion: Lipoproteins, insulin resistance, mediators of systemic and vascular inflammation, and endothelial dysfunction improve after bariatric surgery in obese patients with and without diabetes. Insulin resistance and mediators of vascular inflammation continue to improve beyond 6 months in patients with diabetes. For the first time, we report a positive correlation between a decrease in insulin resistance and change in resistin levels and also between change in BMI and proportional change in leptin.

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