Effects of Roux-en-Y Gastric Bypass on Fasting and Postprandial Levels of the Inflammatory Markers YKL-40 and MCP-1 in Patients with Type 2 Diabetes and Glucose Tolerant Subjects
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Background and aims: The glycoprotein YKL-40 and the chemokine Monocyte Chemoattractant Protein-1 (MCP-1) are elevated in morbidly obese patients and play a role in both diabetic and atherogenic processes. After weight loss induced by bariatric surgery, decreasing levels of several inflammatory markers, including YKL-40 and MCP-1, have been observed in the fasting state, perhaps due to changes in the gut bacterial population and subsequent decrease in bacterial lipopolysaccharide exposure. The objective of our study was to investigate the possible changes of YKL-40 and MCP-1, in both the fasting and the postprandial state, following Roux-en-Y gastric bypass (RYGB) in subjects with either Type 2 Diabetes (T2D) or normal glucose tolerance (NGT).
Materials and methods: Ten obese patients with T2D and ten age and gender matched subjects with NGT were examined in the fasting state and after a 200 ml standard liquid meal (Fresenius Kabi, Germani) prior to and after (1wk, 3 mo and 1yr) RYGB.
Results: No differences in levels of inflammatory markers were observed between the T2D and NGT group before or after RYGB. Fasting state MCP-1 levels decreased after RYGB in both groups (p<0.0001 for both). Fasting YKL-40 levels did not change in either group (p-values ≥ 0.120 for both). Postprandial MCP-1 levels showed a tendency towards a decrease on all study days. I-AUC MCP-1 levels, however, did not change significantly after RYGB, nor were there any differences between the groups on any study day. Generally, postprandial changes of YKL-40 followed the same pattern (a slight decrease followed by an increase) on all study days for both groups. This postprandial suppression of YKL-40 became less pronounced at 1wk and 1 yr in the T2D group (p-values ≤ 0.008 for both). No significant correlations of inflammatory markers with lipid levels, BMI or WHR before or after RYGB were observed
|International Journal of Obesity
|Udgivet - 2013