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Bariatric Surgery Rapidly Decreases Cardiac Dietary Fatty Acid Partitioning and Hepatic Insulin Resistance Through Increased Intra-abdominal Adipose Tissue Storage and Reduced Spillover in Type 2 Diabetes
Diabetes ( IF 7.7 ) Pub Date : 2020-01-08 , DOI: 10.2337/db19-0773
Anne-Marie Carreau 1 , Christophe Noll 1 , Denis P Blondin 1 , Frédérique Frisch 1 , Mélanie Nadeau 2 , Mélissa Pelletier 2 , Serge Phoenix 3 , Stephen C Cunnane 4 , Brigitte Guérin 3 , Eric E Turcotte 3 , Stéfane Lebel 2 , Laurent Biertho 2 , André Tchernof 2, 5 , André C Carpentier 6
Affiliation  

Reduced storage of dietary fatty acids (DFAs) in abdominal adipose tissues with enhanced cardiac partitioning has been shown in subjects with type 2 diabetes (T2D) and prediabetes. We measured DFA metabolism and organ partitioning using positron emission tomography with oral and intravenous long-chain fatty acid and glucose tracers during a standard liquid meal in 12 obese subjects with T2D before and 8–12 days after bariatric surgery (sleeve gastrectomy or sleeve gastrectomy and biliopancreatic diversion with duodenal switch). Bariatric surgery reduced cardiac DFA uptake from a median (standard uptake value [SUV]) 1.75 (interquartile range 1.39–2.57) before to 1.09 (1.04–1.53) after surgery (P = 0.01) and systemic DFA spillover from 56.7 mmol before to 24.7 mmol over 6 h after meal intake after surgery (P = 0.01), with a significant increase in intra-abdominal adipose tissue DFA uptake from 0.15 (0.04–0.31] before to 0.49 (0.20–0.59) SUV after surgery (P = 0.008). Hepatic insulin resistance was significantly reduced in close association with increased DFA storage in intra-abdominal adipose tissues (r = −0.79, P = 0.05) and reduced DFA spillover (r = 0.76, P = 0.01). We conclude that bariatric surgery in subjects with T2D rapidly reduces cardiac DFA partitioning and hepatic insulin resistance at least in part through increased intra-abdominal DFA storage and reduced spillover.

中文翻译:

减肥手术通过增加腹内脂肪组织储存和减少 2 型糖尿病的溢出,迅速降低心脏膳食脂肪酸分配和肝胰岛素抵抗

在 2 型糖尿病 (T2D) 和前驱糖尿病患者中,腹部脂肪组织中膳食脂肪酸 (DFA) 的储存减少,心脏分配增强。我们在 12 名患有 T2D 的肥胖受试者在减肥手术(袖状胃切除术或袖状胃切除术和袖状胃切除术和袖状胃切除术)之前和之后 8-12 天的标准流食期间,使用正电子发射断层扫描和口服和静脉内长链脂肪酸和葡萄糖示踪剂测量了 DFA 代谢和器官分配。用十二指肠开关进行胆胰分流)。减肥手术将心脏 DFA 摄取从手术前的中位数(标准摄取值 [SUV])1.75(四分位距 1.39-2.57)降低到手术后的 1.09(1.04-1.53​​)(P = 0.01),全身 DFA 溢出从手术前的 56.7 mmol 降低到 24.7手术后进餐后超过 6 小时的 mmol (P = 0.01),05)并减少 DFA 溢出(r = 0.76,P = 0.01)。我们得出结论,T2D 受试者的减肥手术至少部分通过增加腹内 DFA 储存和减少溢出来迅速降低心脏 DFA 分配和肝脏胰岛素抵抗。05)并减少 DFA 溢出(r = 0.76,P = 0.01)。我们得出结论,T2D 受试者的减肥手术至少部分通过增加腹内 DFA 储存和减少溢出来迅速降低心脏 DFA 分配和肝脏胰岛素抵抗。
更新日期:2020-01-08
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