Muscle and adipose tissue morphology, insulin sensitivity and beta-cell function in diabetic and nondiabetic obese patients: effects of bariatric surgery.
Muscle and adipose tissue morphology, insulin sensitivity and beta-cell function in diabetic and nondiabetic obese patients: effects of bariatric surgery.
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糖尿病和非糖尿病肥胖患者的肌肉和脂肪组织形态，胰岛素敏感性和β细胞功能：减肥手术的影响。
DOI：
10.1038/s41598-017-08444-6
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发表时间：
2017-08-21
影响因子：
4.6
通讯作者：
Ferrannini E
中科院分区：
文献类型：
--
作者：
Camastra S;Vitali A;Anselmino M;Gastaldelli A;Bellini R;Berta R;Severi I;Baldi S;Astiarraga B;Barbatelli G;Cinti S;Ferrannini E
肥胖症的特征是胰岛素抵抗（IR），脂肪分解增强，异位脂肪发炎。我们将皮下（SAT），内脏脂肪（VAT）和骨骼肌的组织学与代谢异常相关，并在2型糖尿病（T2 D）和体重匹配的非糖尿病（ND）患者中测试减肥手术后它们的相互变化。我们测量了IR（胰岛素钳夹）、脂解（2 H5-甘油输注）、胰岛β细胞葡萄糖敏感性（胰岛β-GS，数学建模）以及VAT、SAT和腹直肌组织学（光镜和电镜）。术前，SAT和VAT显示纤维化/坏死，线粒体变小，间质脂质游离，毛细血管基底膜增厚。与ND相比，T2 D具有受损的β-GS、毛细血管内中性粒细胞和较高的肌细胞内脂肪、VAT中的脂肪细胞面积、VAT中的冠状结构（CLS）和SAT中的罕见结构（囊肿样）比CLS大约10倍。脂肪膨胀与增强的脂解和IR相关。VAT组织学和肌细胞内脂肪与受损的β-GS相关。术后，IR和脂解均改善，T2 D患者的β-GS改善。肌肉脂肪浸润减少，脂肪细胞较小且线粒体丰富，SAT中CLS密度降低。总之，IR与体重减轻成比例地改善，但仍低于正常，而SAT和肌肉变化消失。在T2 D术后，一些VAT病理持续存在，β细胞功能障碍改善但未正常化。
Obesity is characterized by insulin-resistance (IR), enhanced lipolysis, and ectopic, inflamed fat. We related the histology of subcutaneous (SAT), visceral fat (VAT), and skeletal muscle to the metabolic abnormalities, and tested their mutual changes after bariatric surgery in type 2 diabetic (T2D) and weight-matched non-diabetic (ND) patients. We measured IR (insulin clamp), lipolysis (2H5-glycerol infusion), ß-cell glucose-sensitivity (ß-GS, mathematical modeling), and VAT, SAT, and rectus abdominis histology (light and electron microscopy). Presurgery, SAT and VAT showed signs of fibrosis/necrosis, small mitochondria, free interstitial lipids, thickened capillary basement membrane. Compared to ND, T2D had impaired ß-GS, intracapillary neutrophils and higher intramyocellular fat, adipocyte area in VAT, crown-like structures (CLS) in VAT and SAT with rare structures (cyst-like) ~10-fold larger than CLS. Fat expansion was associated with enhanced lipolysis and IR. VAT histology and intramyocellular fat were related to impaired ß-GS. Postsurgery, IR and lipolysis improved in all, ß-GS improved in T2D. Muscle fat infiltration was reduced, adipocytes were smaller and richer in mitochondria, and CLS density in SAT was reduced. In conclusion, IR improves proportionally to weight loss but remains subnormal, whilst SAT and muscle changes disappear. In T2D postsurgery, some VAT pathology persists and beta-cell dysfunction improves but is not normalized.
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影响因子：
4.9
作者：
Eriksson-Hogling, D.;Andersson, D. P.;Ryden, M.
通讯作者：
Ryden, M.
影响因子：
56.9
作者：
FLIER, JS;COOK, KS;SPIEGELMAN, BM
通讯作者：
SPIEGELMAN, BM
影响因子：
7.7
作者：
Greco, AV;Mingrone, G;Ferrannini, E
通讯作者：
Ferrannini, E
影响因子：
6.9
作者：
Lima, Marcelo M. O.;Pareja, Jose C.;Geloneze, Bruno
通讯作者：
Geloneze, Bruno
影响因子：
64.5
作者：
Lo JC;Ljubicic S;Leibiger B;Kern M;Leibiger IB;Moede T;Kelly ME;Chatterjee Bhowmick D;Murano I;Cohen P;Banks AS;Khandekar MJ;Dietrich A;Flier JS;Cinti S;Blüher M;Danial NN;Berggren PO;Spiegelman BM
通讯作者：
Spiegelman BM