Skip to main content

Advertisement

SpringerLink
Log in

Diabetes Associated Markers After Bariatric Surgery: Fetuin-A, but Not Matrix Metalloproteinase-7, Is Reduced

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Recent studies showed that fetuin-A and matrix metalloproteinase-7 (MMP-7) are type 2 diabetes mellitus (T2DM)-associated markers. Bariatric surgery not only reduces body weight but also improves T2DM. This study aimed to investigate the changes of fetuin-A and MMP-7 in obese subjects with and without T2DM after bariatric surgery.

Methods

We enrolled 130 obese subjects that received bariatric surgery, including 41 Roux-en-Y gastric bypass (RYGB), 67 mini-gastric bypass (MGB), and 22 sleeve gastrectomy (SG) patients. Forty-three patients suffered from T2DM prior to surgery. The fasting serum fetuin-A and MMP-7 levels were measured before and 1 year after surgery.

Results

Only five of 43 patients remained diabetic after surgery. Preoperative T2DM patients had higher fetuin-A and MMP-7 levels than non-T2DM subjects. RYGB, MGB, and SG all decreased the fetuin-A levels 1 year after the operation. The MMP-7 levels were not changed after RYGB, MGB, or SG. In multivariate analyses, the preoperative fetuin-A was significantly related to the diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c), while the postoperative fetuin-A was independently related to the waist-to-hip ratio and HbA1c. Moreover, the preoperative MMP-7 level was significantly related to age, DBP, aspartate transaminase, alanine transaminase, and gamma-glutamyl transferase (rGT), while the postoperative MMP-7 level was independently related to age and rGT.

Conclusions

The fetuin-A and MMP-7 levels are both higher in obese T2DM than non-T2DM subjects. The level of fetuin-A is reduced after RYGB, MGB, and SG, but the level of MMP-7 remains unchanged.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Unwin N, Gan D, Whiting D. The IDF Diabetes Atlas: providing evidence, raising awareness and promoting action. Diabetes Res Clin Pract. 2010;87(1):2–3.

    Article  PubMed  Google Scholar 

  2. Zhang P, Zhang X, Brown J, et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(3):293–301.

    Article  PubMed  Google Scholar 

  3. Auberger P, Falquerho L, Contreres JO, et al. Characterization of a natural inhibitor of the insulin receptor tyrosine kinase: cDNA cloning, purification, and anti-mitogenic activity. Cell. 1989;58(4):631–40.

    Article  CAS  PubMed  Google Scholar 

  4. Ix JH, Wassel CL, Kanaya AM, et al. Fetuin-A and incident diabetes mellitus in older persons. JAMA. 2008;300(2):182–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Ishibashi A, Ikeda Y, Ohguro T, et al. Serum fetuin-A is an independent marker of insulin resistance in Japanese men. J Atheroscler Thromb. 2010;17(9):925–33.

    Article  CAS  PubMed  Google Scholar 

  6. Wielockx B, Libert C, Wilson C. Matrilysin (matrix metalloproteinase-7): a new promising drug target in cancer and inflammation? Cytokine Growth Factor Rev. 2004;15(2–3):111–5.

    Article  CAS  PubMed  Google Scholar 

  7. Ban CR, Twigg SM, Franjic B, et al. Serum MMP-7 is increased in diabetic renal disease and diabetic diastolic dysfunction. Diabetes Res Clin Pract. 2010;87(3):335–41.

    Article  CAS  PubMed  Google Scholar 

  8. Kadoglou NP, Sailer N, Fotiadis G, Kapelouzou A, Liapis CD. The impact of type 2 diabetes and atorvastatin treatment on serum levels of MMP-7 and MMP-8. Exp Clin Endocrinol Diabetes. 2014;122(1):44–9.

    Article  CAS  PubMed  Google Scholar 

  9. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  10. Dixon JB, Zimmet P, Alberti KG, Rubino F. Bariatric surgery: an IDF statement for obese type 2 diabetes. Diabet Med. 2011;28(6):628–42.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  CAS  PubMed  Google Scholar 

  12. Lee WJ, Hur KY, Lakadawala M, Kasama K, Wong SK, Lee YC. Gastrointestinal metabolic surgery for the treatment of diabetic patients: a multi-institutional international study. J Gastrointest Surg. 2012;16(1):45–51. discussion −2.

    Article  PubMed  Google Scholar 

  13. Lee WJ, Wang W. Bariatric surgery: Asia-Pacific perspective. Obes Surg. 2005;15(6):751–7.

    Article  PubMed  Google Scholar 

  14. Lee WJ, Yu PJ, Wang W, Chen TC, Wei PL, Huang MT. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242(1):20–8.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Ser KH, Lee WJ, Lee YC, Chen JC, Su YH, Chen SC. Experience in laparoscopic sleeve gastrectomy for morbidly obese Taiwanese: staple-line reinforcement is important for preventing leakage. Surg Endosc. 2010;24(9):2253–9.

    Article  PubMed  Google Scholar 

  16. American Diabetes A. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37 Suppl 1:S14–80.

    Article  Google Scholar 

  17. Li JV, Ashrafian H, Bueter M, et al. Metabolic surgery profoundly influences gut microbial-host metabolic cross-talk. Gut. 2011;60(9):1214–23.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Rao RS, Yanagisawa R, Kini S. Insulin resistance and bariatric surgery. Obes Rev. 2012;13(4):316–28.

    Article  CAS  PubMed  Google Scholar 

  19. Stefater MA, Wilson-Perez HE, Chambers AP, Sandoval DA, Seeley RJ. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev. 2012;33(4):595–622.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Ix JH, Shlipak MG, Brandenburg VM, Ali S, Ketteler M, Whooley MA. Association between human fetuin-A and the metabolic syndrome: data from the Heart and Soul Study. Circulation. 2006;113(14):1760–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Ix JH, Biggs ML, Mukamal KJ, et al. Association of fetuin-a with incident diabetes mellitus in community-living older adults: the cardiovascular health study. Circulation. 2012;125(19):2316–22.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. Brix JM, Stingl H, Hollerl F, Schernthaner GH, Kopp HP, Schernthaner G. Elevated Fetuin-A concentrations in morbid obesity decrease after dramatic weight loss. J Clin Endocrinol Metab. 2010;95(11):4877–81.

    Article  CAS  PubMed  Google Scholar 

  23. Reinehr T, Roth CL. Fetuin-A and its relation to metabolic syndrome and fatty liver disease in obese children before and after weight loss. J Clin Endocrinol Metab. 2008;93(11):4479–85.

    Article  CAS  PubMed  Google Scholar 

  24. LaFramboise WA, Dhir R, Kelly LA, et al. Serum protein profiles predict coronary artery disease in symptomatic patients referred for coronary angiography. BMC Med. 2012;10:157.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Ress C, Tschoner A, Ciardi C, et al. Influence of significant weight loss on serum matrix metalloproteinase (MMP)-7 levels. Eur Cytokine Netw. 2010;21(1):65–70.

    CAS  PubMed  Google Scholar 

  26. Jiang S, Jiang D, Tao Y. Role of gamma-glutamyltransferase in cardiovascular diseases. Exp Clin Cardiol. 2013;18(1):53–6.

    PubMed Central  CAS  PubMed  Google Scholar 

  27. Du G, Song Z, Zhang Q. Gamma-glutamyltransferase is associated with cardiovascular and all-cause mortality: a meta-analysis of prospective cohort studies. Prev Med. 2013;57(1):31–7.

    Article  PubMed  Google Scholar 

  28. Nilsson L, Jonasson L, Nijm J, Hamsten A, Eriksson P. Increased plasma concentration of matrix metalloproteinase-7 in patients with coronary artery disease. Clin Chem. 2006;52(8):1522–7.

    Article  CAS  PubMed  Google Scholar 

  29. Jullig M, Yip S, Xu A, et al. Lower fetuin-A, retinol binding protein 4 and several metabolites after gastric bypass compared to sleeve gastrectomy in patients with type 2 diabetes. PLoS One. 2014;9(5):e96489.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This project is in part supported by a grant from the National Science Council of Taiwan (NSC: 102-2325-B-002-062 from NRPB 101CV1005).

Conflict of Interest

All the contributing authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human Rights

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Author information

Author notes

    Authors and Affiliations

    1. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

      Po-Jen Yang, Hsiao-Ching Nien & Wei-Shiung Yang

    2. Department of Surgery, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan

      Po-Jen Yang

    3. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan

      Po-Jen Yang, Ming-Tsan Lin & Chiung-Nien Chen

    4. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan

      Kong-Han Ser & Wei-Jei Lee

    5. Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan

      Hsiao-Ching Nien

    6. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

      Wei-Shiung Yang

    Authors
    1. Po-Jen Yang
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Kong-Han Ser
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Ming-Tsan Lin
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Hsiao-Ching Nien
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Chiung-Nien Chen
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Wei-Shiung Yang
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Wei-Jei Lee
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Wei-Jei Lee.

    Additional information

    Wei-Shiung Yang and Wei-Jei Lee contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Yang, PJ., Ser, KH., Lin, MT. et al. Diabetes Associated Markers After Bariatric Surgery: Fetuin-A, but Not Matrix Metalloproteinase-7, Is Reduced. OBES SURG 25, 2328–2334 (2015). https://doi.org/10.1007/s11695-015-1688-5

    Download citation

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s11695-015-1688-5

    Keywords

    Search

    Navigation