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

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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.

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Acknowledgments

The funds were provided by the Sao Paulo Research Foundation—FAPESP, grants n. 2008/09451-7 and n. 2008/07312-0.

Conflict of Interest

The authors 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 and Bruno Geloneze declare that they have no conflict of interest reported.

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.”

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Authors and Affiliations

  1. School of Applied Sciences (FCA), State University of Campinas, UNICAMP, Limeira, São Paulo, Brazil

    Ana Carolina Junqueira Vasques

  2. Laboratory of Investigation on Metabolism and Diabetes (LIMED), Gastrocentro, Faculty of Medical Sciences, State University of Campinas, UNICAMP, 420, Carlos Chagas St, Cidade Universitária “Zeferino Vaz”, 13081-970, Campinas, SP, Brazil

    Ana Carolina Junqueira Vasques, José Carlos Pareja, Ademar Yamanaka, Maria da Saúde de Oliveira, Fernanda Satake Novaes & Bruno Geloneze

  3. Diabetic Surgery Unit, Department of Surgery, State University of Campinas, UNICAMP, Campinas, São Paulo, Brazil

    José Carlos Pareja & Élinton Adami Chaim

  4. Department of Cardiology, Faculty of Medical Sciences, State University of Campinas, UNICAMP, Campinas, São Paulo, Brazil

    José Roberto Mattos Souza

  5. Department of Information Engineering, University of Padova, Padova, Italy

    Francesca Piccinini, Chiara Dalla Man & Claudio Cobelli

Authors
  1. Ana Carolina Junqueira Vasques
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  2. José Carlos Pareja
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Corresponding author

Correspondence to Ana Carolina Junqueira Vasques.

Additional information

UTN Number: U1111-1137-0489/Brazilian Registry of Clinical Trials—ReBEC: RBR-9kdzdv.

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Vasques, A.C.J., Pareja, J.C., Souza, J.R.M. et al. Epicardial and Pericardial Fat in Type 2 Diabetes: Favourable Effects of Biliopancreatic Diversion. OBES SURG 25, 477–485 (2015). https://doi.org/10.1007/s11695-014-1400-1

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  • DOI: https://doi.org/10.1007/s11695-014-1400-1

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