Obesity Surgery

, Volume 25, Issue 3, pp 477–485

Epicardial and Pericardial Fat in Type 2 Diabetes: Favourable Effects of Biliopancreatic Diversion

  • Ana Carolina Junqueira Vasques
  • José Carlos Pareja
  • José Roberto Mattos Souza
  • Ademar Yamanaka
  • Maria da Saúde de Oliveira
  • Fernanda Satake Novaes
  • Élinton Adami Chaim
  • Francesca Piccinini
  • Chiara Dalla Man
  • Claudio Cobelli
  • Bruno Geloneze
Original Contributions

Abstract

Purpose

Ectopic fat is often identified in obese subjects who are susceptible to the development of type 2 diabetes mellitus (T2DM). The ectopic fat favours the decrease in insulin sensitivity (IS) and adiponectin levels. We aimed to evaluate the effect of biliopancreatic diversion (BPD) on the accumulation of ectopic fat, adiponectin levels and IS in obese with T2DM.

Materials and Methods

A nonrandomised controlled study was performed on sixty-eight women: 19 lean-control (23.0 ± 2.2 kg/m2) and 18 obese-control (35.0 ± 4.8 kg/m2) with normal glucose tolerance and 31 obese with T2DM (36.3 ± 3.7 kg/m2). Of the 31 diabetic women, 20 underwent BPD and were reassessed 1 month and 12 months after surgery. The subcutaneous adipose tissue, visceral adipose tissue, epicardial adipose tissue and pericardial adipose tissue were evaluated by ultrasonography. The IS was assessed by a hyperglycaemic clamp, applying the minimal model of glucose.

Results

One month after surgery, there was a reduction in visceral and subcutaneous adipose tissues, whereas epicardial and pericardial adipose tissues exhibited significant reduction at the 12-month assessment (p < 0.01). Adiponectin levels and IS were normalised 1 month after surgery, resembling lean-control values and elevated above the obese-control values (p < 0.01). After 12 months, the improvement in IS and adiponectin was maintained, and 17 of the 20 operated patients exhibited fasting glucose and glycated haemoglobin within the normal range.

Conclusions

After BPD, positive physiological adaptations occurred in grade I and II obese patients with T2DM. These adaptations relate to the restoration of IS and decreased adiposopathy and explain the acute (1 month) and chronic (12 months) improvements in the glycaemic control.

Keywords

Epicardial adipose tissue Obesity Type 2 diabetes mellitus Biliopancreatic diversion surgery Hyperglycaemic clamp Insulin sensitivity 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ana Carolina Junqueira Vasques
    • 1
    • 2
  • José Carlos Pareja
    • 2
    • 3
  • José Roberto Mattos Souza
    • 4
  • Ademar Yamanaka
    • 2
  • Maria da Saúde de Oliveira
    • 2
  • Fernanda Satake Novaes
    • 2
  • Élinton Adami Chaim
    • 3
  • Francesca Piccinini
    • 5
  • Chiara Dalla Man
    • 5
  • Claudio Cobelli
    • 5
  • Bruno Geloneze
    • 2
  1. 1.School of Applied Sciences (FCA)State University of Campinas, UNICAMPLimeiraBrazil
  2. 2.Laboratory of Investigation on Metabolism and Diabetes (LIMED), Gastrocentro, Faculty of Medical SciencesState University of Campinas, UNICAMPCampinasBrazil
  3. 3.Diabetic Surgery Unit, Department of SurgeryState University of Campinas, UNICAMPCampinasBrazil
  4. 4.Department of Cardiology, Faculty of Medical SciencesState University of Campinas, UNICAMPCampinasBrazil
  5. 5.Department of Information EngineeringUniversity of PadovaPadovaItaly

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