Evolution of subcutaneous adipose tissue fibrosis after bariatric surgery
Evolution of subcutaneous adipose tissue fibrosis after bariatric surgery
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DOI：
10.1016/j.diabet.2016.10.004
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发表时间：
2017-04-01
影响因子：
7.2
通讯作者：
Rabasa-Lhoret, R.
中科院分区：
文献类型：
--
作者：
Chabot, K.;Gauthier, M. -S.;Rabasa-Lhoret, R.
的目标。肥胖与胰岛素抵抗（IR）等代谢并发症的发生有关。导致IR的机制尚不清楚。本研究旨在探讨肥胖患者减肥手术前后脂肪组织纤维化与IR的关系。- 35名等待减肥手术的肥胖患者（12名患有2型糖尿病）被纳入研究。根据松田胰岛素敏感指数（ISImatsuda）将非糖尿病患者分为胰岛素敏感（n = 11）和胰岛素抵抗（n = 12）两组。采用稳态模型评估（HOMA-IR）对胰岛素抵抗进行纵向评估。通过显微镜下马氏三色染色定量纤维化，并在减肥手术（仅限SAT）期间和术后6个月收集的皮下（SAT）和内脏脂肪组织（VAT）活检中检测纤维化相关基因的mRNA水平。-尽管年龄、体重指数和脂肪量相似，但糖尿病患者的SAT纤维化明显高于胰岛素敏感患者（P < 0.05），并且在基线时ISImatsuda （r= 0.417, P = 0.038）和HOMA-IR （r= 0.464, P = 0.007）评估与IR相关，而VAT纤维化则没有。手术后6个月，体重明显减轻，SAT患者的纤维化水平保持不变，尽管所有组的IR均显著降低（P < 0.0001）。术后SAT纤维化与IR无相关性。总的来说，这些结果显示肥胖人群中SAT纤维化和IR之间存在显著但很可能是短暂的关联。(C) 2016 Elsevier Masson SAS。版权所有。
Aim. - Obesity is associated with the development of metabolic complications such as insulin resistance (IR). The mechanisms leading to IR remain unclear. This study aimed to investigate the relationship between adipose tissue fibrosis and IR in obese patients before and after bariatric surgery.Methods. - Thirty-five obese patients awaiting bariatric surgery (12 with type 2 diabetes) were included in the study. Non -diabetic patients were classified as either insulin -sensitive (n = 11) or insulin -resistant (n = 12), based on the Matsuda insulin sensitivity index (ISImatsuda). Homoeostasis model assessment (HOMA-IR) was used for longitudinal evaluation of insulin resistance. Fibrosis was quantified by Masson's trichrome staining on microscopy, and mRNA levels of fibrosis-related genes were examined in subcutaneous (SAT) and visceral adipose tissue (VAT) biopsies collected during and 6 months after bariatric surgery (SAT only).Results. - Despite their similar age, body mass index and fat mass, SAT fibrosis was significantly higher in diabetic vs insulin -sensitive patients (P < 0.05), and associated with IR as assessed by both ISImatsuda (r= 0.417, P = 0.038) and HOMA-IR (r= 0.464, P = 0.007) at baseline, whereas VAT fibrosis was not. Six months after surgery and significant weight loss, fibrosis levels remained unchanged in SAT, although IR was significantly reduced in all groups (P < 0.0001). No correlation was found between SAT fibrosis and IR after surgery.Conclusion. - Overall, these results show a significant but, most likely, transient association between SAT fibrosis and IR in obese humans. (C) 2016 Elsevier Masson SAS. All rights reserved.