Adipose Tissue and Plasma Markers Associated with HbA1c Pre- and Post-bariatric Surgery: a Cross-sectional and Cohort Study

Purpose Obesity can be associated with chronic inflammation and dysregulated expression of inflammatory adipokines that contribute to insulin resistance and type 2 diabetes. This may also affect the clinical response to bariatric surgery. Our objective was whether baseline visceral adipose tissue fe...

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Published in:Obesity surgery 2023-08, Vol.33 (8), p.2443-2451
Main Authors: Keshavjee, Sara H., Schwenger, Katherine J. P., Yadav, Jitender, Pickel, Lauren, Ghorbani, Yasaman, Sung, Hoon-Ki, Jung, Hyejung, Lou, Wendy, Fischer, Sandra E., Jackson, Timothy D., Okrainec, Allan, Allard, Johane P.
Format: Article
Language:English
Subjects:
Body fat
Cohort analysis
Diabetes
Gastrointestinal surgery
Insulin resistance
Medicine
Medicine & Public Health
Obesity
Original Contributions
Plasma
Surgery
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Summary:Purpose Obesity can be associated with chronic inflammation and dysregulated expression of inflammatory adipokines that contribute to insulin resistance and type 2 diabetes. This may also affect the clinical response to bariatric surgery. Our objective was whether baseline visceral adipose tissue features and plasma adipokine are associated with HbA1c ≥0.06 at the time of Roux-en-Y gastric bypass (RYGB) surgery and with persistently elevated HbA1c at 12 months post-RYGB. Methods During the surgery, adipose biopsies and plasma were collected for adipokine/cytokine profile. Clinical and biochemical measurements were also collected at the time of RYGB and, in those with baseline elevated HbA1c, at 12 months post-RYGB. Results In the cross-sectional study, 109 patients (82.6% female; age 49 years; BMI 46.98 kg/m 2 ) participated. Of those with elevated HbA1c at baseline ( n = 61), 47 patients had repeated measurements at 12 months post-RYGB (23% drop-out). Using a multivariate logistic regression model, older age (adjusted odds ratio (aOR), 1.14; 95% confidence interval (CI), 1.06–1.22) and higher plasma resistin (aOR, 5.30; 95% CI, 1.25–22.44) were associated with higher odds of HbA1c ≥ 0.06, whereas higher plasma adiponectin (aOR, 0.993; 95% CI, 0.99–0.996) was associated with lower odds of HbA1c ≥0.06. In addition, baseline higher average adipose cell area (aOR, 1.0017; 95% CI, 1.0002–1.0032) and plasma resistin (aOR, 1.0004; 95% CI, 1.0000–1.0009) were associated with higher odds of having persistently elevated HbA1c at 12 months post-RYGB. Conclusion Our study suggests that baseline plasma adipokine dysregulation, specifically high resistin, and adipocyte hypertrophy may affect the clinical response to RYGB. Graphical Abstract
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-023-06679-z