Lipoprotein insulin resistance score in nondiabetic patients with obesity after bariatric surgery |
| |
| Affiliation: | 1. Department of Medicine, Leon H. Charney Division of Cardiology & Center for the Prevention of Cardiovascular Disease, NYU Langone Medical Center, NYU School of Medicine, New York, New York;2. Department of Surgery, NYU Langone Medical Center, NYU School of Medicine, New York, New York;3. Department of Medicine, Division of Endocrinology, NYU Langone Medical Center, NYU School of Medicine, New York, New York;1. Bariatric Unit, Humanitas Research Hospital, IRCCS Rozzano, Italy;2. Bariatric & Metabolic Surgery Unit, Department of General Surgery, Pisa, Italy;3. SOC Malattie infettive, Azienda Sanitaria Integrata, University of Udine Udine, Italy;4. Bariatric & Metabolic Surgery Unit, Department of medical and surgical sciences, Azienda Ospedaliera Universitaria Policlinico di Sant’Orsola Bologna, Bologna, Italy;5. Week Surgery – Bariatric Unit, Padova University Hospital, University of Padova, Padova, Italy;6. Obesity Unit, Department of Surgery, Tor Vergata University, Roma, Italy;7. General Surgery, Department of Surgical Sciences, University of Torino, Torino, Italy;8. General and Oncological Surgery, Center of Advanced Laparoscopy, Center of Bariatric and Metabolic Surgery, Zingonia, Italy;9. Division of General Surgery & Bariatric Center of Excellence IFSO EC, Department of Medico-Surgical Sciences and Biothecnologies, Sapienza University of Rome, Latina, Italy;1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota;2. Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida;3. Division of Surgery, Mayo Clinic, Rochester, Minnesota;4. Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona;5. ABC Medical School, Sao Paulo, Brazil;6. Orlando Regional Medical Center, Orlando Health, Orlando, Florida;1. Department of Biochemistry and Molecular Biomedicine, Biology Faculty, University of Barcelona, Barcelona, Spain;2. Gastrointestinal Surgery Department, Arnau de Vilanova University Hospital, IRB Lleida, University of Lleida, Lleida, Spain;3. Endocrinology and Nutrition Department, Arnau de Vilanova University Hospital, Obesity, Diabetes and Metabolism research group, IRBLleida, University of Lleida, Lleida, Spain;4. Department of Genetics, Microbiology and Statistics, Biology Faculty, University of Barcelona, Barcelona, Spain;5. Vascular and Renal Translational Research Group, IRB Lleida, RedinRen-ISCIII, Lleida, Spain;6. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain;1. Center for Translational Sciences, Children’s National Health System, Washington, DC;2. Department of Pediatrics, George Washington University, Washington, DC;3. Department of Surgery, Children’s National Health System, Washington, DC;1. Department of Surgery, Division of Metabolic and Weight Loss Surgery, Duke University, Durham, North Carolina;2. Duke Biostatistics, Epidemiology, Research and Design (BERD) Methods Core, Duke University, Durham, North Carolina;3. Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina;4. Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Duke University School of Medicine, Durham, North Carolina;1. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio;2. Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island;3. University of North Carolina School of Medicine, Chapel Hill, North Carolina;4. Department of Psychiatry and Behavioral Science, Sanford Center for Biobehavioral Research, Fargo, North Dakota;5. University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota;6. University of North Carolina School of Medicine at Charlotte, Charlotte, North Carolina;7. Department of Psychological Science and Brain Health Research Institute, Kent State University, Kent, Ohio;8. North Dakota State University, Fargo, North Dakota;9. University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota |
| |
| Abstract: | BackgroundLipoprotein insulin resistance (LPIR) score is a composite biomarker representative of atherogenic dyslipidemia characteristic of early insulin resistance. It is elevated in obesity and may provide information not captured in glycosylated hemoglobin and homeostatic model assessment for insulin resistance. While bariatric surgery reduces diabetes incidence and resolves metabolic syndrome, the effect of bariatric surgery on LPIR is untested.ObjectivesWe sought to assess the effects of Roux-en-Y gastric bypass and sleeve gastrectomy on LPIR in nondiabetic women with obesity.SettingNonsmoking, nondiabetic, premenopausal Hispanic women, age ≥18 years, undergoing Roux-en-Y gastric bypass or sleeve gastrectomy at Bellevue Hospital were recruited for a prospective observational study.MethodsAnthropometric measures and blood sampling were performed preoperatively and at 6 and 12 months postoperatively. LPIR was measured by nuclear magnetic resonance spectroscopy.ResultsAmong 53 women (Roux-en-Y gastric bypass, n = 22; sleeve gastrectomy, n = 31), mean age was 32 ± 7 years and body mass index 44.1 ± 6.4 kg/m2. LPIR was reduced by 35 ± 4% and 46 ± 4% at 6 and 12 months after surgery, respectively, with no difference by procedure. Twenty-seven of 53 patients met International Diabetes Federation criteria for metabolic syndrome preoperatively and had concomitant higher homeostatic model assessment for insulin resistance, glycosylated hemoglobin, nonhigh-density lipoprotein-cholesterol and LPIR. Twenty-five of 27 patients experienced resolution of metabolic syndrome postoperatively. Concordantly, the preoperative differences in homeostatic model assessment for insulin resistance, glycosylated hemoglobin, and nonhigh-density lipoprotein-cholesterol between those with and without metabolic syndrome resolved at 6 and 12 months. In contrast, patients with metabolic syndrome preoperatively exhibited greater LPIR scores at 6 and 12 months postoperatively.ConclusionThis is the first study to demonstrate improvement in insulin resistance, as measured by LPIR, after bariatric surgery with no difference by procedure. This measure, but not traditional markers, was persistently higher in patients with a preoperative metabolic syndrome diagnosis, despite resolution of the condition. |
| |
| Keywords: | Lipoprotein insulin resistance score Insulin resistance Metabolic syndrome Bariatric surgery Dyslipidemia Cardiometabolic risk |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
