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. 2013 Mar-Apr;9(2):207-12.
doi: 10.1016/j.soard.2011.09.026. Epub 2011 Oct 14.

Restoration of glycemic control in patients with type 2 diabetes mellitus after bariatric surgery is associated with reduction in microparticles

Vicky Cheng  1 , Sangeeta R Kashyap, Philip R Schauer, John P Kirwan, Keith R McCrae
Affiliations

Restoration of glycemic control in patients with type 2 diabetes mellitus after bariatric surgery is associated with reduction in microparticles

Vicky Cheng et al. Surg Obes Relat Dis. 2013 Mar-Apr.

Abstract

Background: Microparticles bud from cellular elements during inflammation and are associated with the vascular dysfunction related to type 2 diabetes mellitus. Although weight loss is known to reduce inflammation, the metabolic effects of bariatric surgery on microparticle concentration and composition are not known. Our objectives were to determine the effect of bariatric surgery on the microparticle concentration and to correlate these changes with clinical parameters in a multispecialty group practice.

Methods: We studied 14 obese subjects with type 2 diabetes mellitus 2 weeks before and 1 and 12 months after bariatric surgery. Of the 14 patients, 9 underwent Roux-en-Y gastric bypass and 5 gastric restrictive surgery.

Results: At 1 month after surgery, the body mass index had decreased by ∼10%, glycemic control had improved dramatically (P < .01), and a >60% reduction in endothelial and platelet microparticles and C-reactive protein levels (P < .05) had occurred. The tissue factor microparticles had decreased by 40% (P = .1). At 12 months after surgery, the body mass index had decreased by ∼20%, glycemic control was maintained (P < .01), and a >50% reduction in monocyte microparticles compared with before surgery was found. The reduction in monocyte microparticles 1 month after surgery was strongly associated with the reduction in hemoglobin A1c (P < .05). The reduction in monocyte microparticles 12 months after surgery correlated strongly with the reduction in body mass index (P < .05).

Conclusion: The reduction in microparticles after bariatric surgery in patients with type 2 diabetes mellitus reflects an attenuation of inflammation, and this mechanism might contribute to normalization of glycemic control.

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Figures

Figure 1
Figure 1. Microparticle concentrations before and after surgery
CD 14, monocyte microparticles. CD 144, endothelial microparticles. CD 41, platelet microparticles. †Presurgery vs. 1 month after surgery (p <0.05). *Presurgery vs. 12 months after surgery (p <0.05).
Figure 2
Figure 2
Figure 2a : Correlation between CD14 (monocyte microparticles) concentration and hemoglobin A1c one month after surgery Figure 2b : Correlation between CD 14 (monocyte microparticles) concentration and body mass index 12 months after surgery
Figure 2
Figure 2
Figure 2a : Correlation between CD14 (monocyte microparticles) concentration and hemoglobin A1c one month after surgery Figure 2b : Correlation between CD 14 (monocyte microparticles) concentration and body mass index 12 months after surgery
See this image and copyright information in PMC

References

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