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Obesity Surgery
Published in: Obesity Surgery 3/2010

01-03-2010 | Clinical Research

Urinary Albumin Excretion, HMW Adiponectin, and Insulin Sensitivity in Type 2 Diabetic Patients Undergoing Bariatric Surgery

Authors: Sankar D. Navaneethan, Karen R. Kelly, Firas Sabbagh, Philip R. Schauer, John P. Kirwan, Sangeeta R. Kashyap

Published in: Obesity Surgery | Issue 3/2010

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Abstract

Background

Microalbuminuria portends an increased risk for renal and cardiovascular diseases in diabetes. In this pilot study, we determined the effect of weight loss induced by different types of bariatric surgery on albuminuria in severely obese type 2 diabetic (T2DM) subjects.

Methods

Fifteen consecutive T2DM patients (9M/6F, 51 ± 14 years, body mass index (BMI) 49 ± 9 kg/m2, HbA1c 7.2 ± 1.1%) undergoing either Roux-en-Y gastric bypass (RYGB; N = 9) or other types of bariatric surgery (N = 6) underwent determination of urine albumin/creatinine ratio (UACR) and adipokine and insulin sensitivity during a mixed meal tolerance test performed 2 weeks prior to and 6 months following surgery.

Results

Following RYGB, there was a significant decrease in BMI (−4.74 ± −5.05 kg/m2), fasting glucose, cholesterol, and leptin levels. Insulin sensitivity (Matsuda index [12.05 ± 3.81, p = 0.003]) and high molecular weight (HMW) adiponectin increased significantly along with a significant reduction in UACR (median, 36 mg/g [7–94] vs. 27 mg/g [5.5–42.5], p = 0.01). The reduction in UACR following RYGB was inversely correlated with the Matsuda index (r = −0.74, p = 0.02) and HMW adiponectin (r = −0.67, p = 0.04). In contrast, despite reduction in BMI (−4.11 ± −4.10 kg/m2) following other types of bariatric surgery (n = 6), there was no significant improvement in insulin sensitivity (0.88 ± 2.40, p = 0.63), UACR, or HMW adiponectin levels.

Conclusions

RYGB in severely obese DM subjects is associated with a reduction in albuminuria that correlates to the improvement in insulin sensitivity and HMW adiponectin. The data point to a need for larger studies to confirm these findings and evaluate the micro–macrovascular benefits including renal parenchymal benefits of different types of bariatric surgery in T2DM.
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Metadata
Title
Urinary Albumin Excretion, HMW Adiponectin, and Insulin Sensitivity in Type 2 Diabetic Patients Undergoing Bariatric Surgery
Authors
Sankar D. Navaneethan
Karen R. Kelly
Firas Sabbagh
Philip R. Schauer
John P. Kirwan
Sangeeta R. Kashyap
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 3/2010
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-009-0026-1

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