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
Open Access
- 1 April 2020
- journal article
- research article
- Published by American Diabetes Association in Diabetes
- Vol. 69 (4), 567-577
- https://doi.org/10.2337/db19-0773
Abstract
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.Funding Information
- Canadian Institutes of Health Research (341582, 299962, TB2-138776)
- Johnson & Johnson Medical Companies
- Diabetes Canada
- Fonds de Recherche du Québec - Santé
This publication has 48 references indexed in Scilit:
- Fatty Acid Metabolic Remodeling During Type 2 Diabetes Remission After Bariatric SurgeryDiabetes, 2017
- Biliopancreatic diversion with duodenal switch leads to better postprandial glucose level and beta cell function than sleeve gastrectomy in individuals with type 2 diabetes very early after surgeryMetabolism, 2017
- Early Metabolic Improvement After Bariatric Surgery: The First Steps Toward Remission of Type 2 DiabetesCanadian Journal of Diabetes, 2017
- Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year OutcomesThe New England Journal of Medicine, 2017
- Ectopic Fat in Insulin Resistance, Dyslipidemia, and Cardiometabolic DiseaseThe New England Journal of Medicine, 2014
- Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomySurgery for Obesity and Related Diseases, 2014
- Association of Bariatric Surgery With Long-term Remission of Type 2 Diabetes and With Microvascular and Macrovascular ComplicationsJAMA, 2014
- Biliopancreatic diversion with duodenal switch improves insulin sensitivity and secretion through caloric restrictionObesity, 2014
- Early Enhancements of Hepatic and Later of Peripheral Insulin Sensitivity Combined With Increased Postprandial Insulin Secretion Contribute to Improved Glycemic Control After Roux-en-Y Gastric BypassDiabetes, 2014
- Early and longer term effects of gastric bypass surgery on tissue-specific insulin sensitivity and beta cell function in morbidly obese patients with and without type 2 diabetesDiabetologia, 2011