Abstract
Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m 2 , fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p < 0.001) and small, dense low-density lipoprotein (p < 0.001) decreased, while high-density lipoprotein cholesterol increased (p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.
| Original language | English |
|---|---|
| Pages (from-to) | 144-152 |
| Number of pages | 9 |
| Journal | Diabetes and Vascular Disease Research |
| Volume | 16 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Mar 2019 |
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Keywords
- bariatric surgery
- Insulin resistance
- metabolic syndrome
- obesity
- Reaven’s hypothesis
- triglycerides
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Cardiology and Cardiovascular Medicine
Cite this
Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis : Small, dense low-density lipoprotein and interleukin-6. / Adam, Safwaan; Liu, Yifen; Siahmansur, Tarza; Ho, Jan H.; Dhage, Shaishav S.; Yadav, Rahul; New, John P.; Donn, Rachelle; Ammori, Basil J.; Syed, Akheel A.; Malik, Rayaz; Soran, Handrean; Durrington, Paul N.
In: Diabetes and Vascular Disease Research, Vol. 16, No. 2, 01.03.2019, p. 144-152.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bariatric surgery as a model to explore the basis and consequences of the Reaven hypothesis
T2 - Small, dense low-density lipoprotein and interleukin-6
AU - Adam, Safwaan
AU - Liu, Yifen
AU - Siahmansur, Tarza
AU - Ho, Jan H.
AU - Dhage, Shaishav S.
AU - Yadav, Rahul
AU - New, John P.
AU - Donn, Rachelle
AU - Ammori, Basil J.
AU - Syed, Akheel A.
AU - Malik, Rayaz
AU - Soran, Handrean
AU - Durrington, Paul N.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m 2 , fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p < 0.001) and small, dense low-density lipoprotein (p < 0.001) decreased, while high-density lipoprotein cholesterol increased (p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.
AB - Background: Reaven originally described the clustering of insulin resistance/hyperinsulinaemia, obesity (particularly visceral), altered cytokine levels, glucose intolerance, hypertriglyceridaemia and low high-density lipoprotein cholesterol. Subsequently, a potentially highly atherogenic small, dense low-density lipoprotein was also reported. We have studied the effect of bariatric surgery on this and other risk factors for atherosclerosis. Methods: Forty patients (20 with type 2 diabetes mellitus) undergoing bariatric surgery were studied before and 1 year after bariatric surgery. Results: Twelve months after bariatric surgery, median body mass index had decreased from 49.5 to 36.5 kg/m 2 , fasting insulin from 21.3 to 7.8 mU/L and insulin resistance (homeostatic model assessment of insulin resistance) from 5.9 to 1.8 (all p < 0.001). Thirteen out of 20 patients had remission from type 2 diabetes mellitus. Highly sensitive C-reactive protein, interleukin-6, fasting triglycerides (p < 0.001) and small, dense low-density lipoprotein (p < 0.001) decreased, while high-density lipoprotein cholesterol increased (p < 0.001) significantly, irrespective of having type 2 diabetes mellitus and/or being treated with statin therapy before surgery. Conclusion: The association between marked weight loss and change in insulin resistance and hyperinsulinaemia with the change in small, dense low-density lipoprotein and interleukin-6 warrants further investigation. Bariatric surgery provides a model for investigating the mechanisms linking insulin resistance/hyperinsulinaemia to atherosclerosis.
KW - bariatric surgery
KW - Insulin resistance
KW - metabolic syndrome
KW - obesity
KW - Reaven’s hypothesis
KW - triglycerides
UR - http://www.scopus.com/inward/record.url?scp=85064928012&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85064928012&partnerID=8YFLogxK
U2 - 10.1177/1479164119826479
DO - 10.1177/1479164119826479
M3 - Article
VL - 16
SP - 144
EP - 152
JO - Diabetes and Vascular Disease Research
JF - Diabetes and Vascular Disease Research
SN - 1479-1641
IS - 2
ER -