, Volume 56, Issue 12, pp 2564–2572

Immune cell-mediated inflammation and the early improvements in glucose metabolism after gastric banding surgery

  • Katherine Samaras
  • Alexander Viardot
  • Natalia K. Botelho
  • Alicia Jenkins
  • Reginald V. Lord

DOI: 10.1007/s00125-013-3033-7

Cite this article as:
Samaras, K., Viardot, A., Botelho, N.K. et al. Diabetologia (2013) 56: 2564. doi:10.1007/s00125-013-3033-7



The contribution of immune cells to the inflammasome that characterises type 2 diabetes mellitus and obesity is under intense research scrutiny. We hypothesised that early changes in glucose metabolism following gastric banding surgery may relate to systemic inflammation, particularly cell-mediated immunity.


Obese participants (BMI 43.4 ± 4.9 kg/m2, n = 15) with diabetes or impaired glucose tolerance (IGT) underwent laparoscopic adjustable gastric banding surgery. Measurements taken before, and at 2 and 12 weeks after surgery included: fasting glucose, glucose levels 2 h after a 75 g oral load, glucose incremental AUC, oral glucose insulin sensitivity index (OGIS), circulating immune cell numbers and activation, and adipokine levels. Subcutaneous and visceral adipose tissue were collected at surgery, and macrophage number and activation measured.


There were significant reductions in fasting and 2 h glucose, as well as improved OGIS at 2 and 12 weeks. At 12 weeks, 80% of the diabetic participants reverted to normal glucose tolerance or IGT, and all IGT participants had normalised glucose tolerance. The 12 week fall in fasting glucose was significantly related to baseline lymphocyte and T lymphocyte numbers, and to granulocyte activation, but also to the magnitude of the 12 week reduction in lymphocyte and T lymphocyte numbers and TNF-α levels. In a model that explained 75% of the variance in the change in fasting glucose, the 12 week change in T lymphocytes was independently associated with the 12 week fall in fasting glucose.


Rapid improvements in glucose metabolism after gastric banding surgery are related to reductions in circulating pro-inflammatory immune cells, specifically T lymphocytes. The contribution of immune cell-mediated inflammation to glucose homeostasis in type 2 diabetes and its improvement after bariatric surgery require further investigation.


Adipokine Bariatric surgery Diabetes Glucose Immune cells Inflammation Insulin resistance Lymphocyte Obesity Tumour necrosis factor-α Weight loss 



C-reactive protein


Impaired glucose tolerance


Oral glucose insulin sensitivity index


Subcutaneous adipose tissue


Visceral adipose tissue

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Katherine Samaras
    • 1
    • 2
  • Alexander Viardot
    • 1
  • Natalia K. Botelho
    • 3
  • Alicia Jenkins
    • 4
  • Reginald V. Lord
    • 3
    • 5
  1. 1.Diabetes and Obesity Research ProgramGarvan Institute of Medical ResearchDarlinghurstAustralia
  2. 2.Department of EndocrinologySt Vincent’s HospitalDarlinghurstAustralia
  3. 3.St Vincent’s Centre for Applied Medical ResearchUniversity of NSWDarlinghurstAustralia
  4. 4.Department of EndocrinologySt Vincent’s HospitalMelbourneAustralia
  5. 5.Department of SurgeryNotre Dame School of MedicineSydneyAustralia

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