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01-05-2018 | Original Contributions

γ-Glutamyltransferase Fractions in Obese Subjects with Type 2 Diabetes: Relation to Insulin Sensitivity and Effects of Bariatric Surgery

Authors: Maria Franzini, Veronica Musetti, Daniela Guarino, Laura Caponi, Aldo Paolicchi, Michele Emdin, Ele Ferrannini, Monica Nannipieri

Published in: Obesity Surgery | Issue 5/2018

Abstract

Background/Objectives

Gamma-glutamyltranspeptidase (GGT) levels are an independent risk marker for the development of type 2 diabetes (T2DM). We investigated the relationship between the newly identified serum GGT fractions and glucose metabolism in obese subjects before and after bariatric surgery.

Subjects/Methods

Twenty-nine T2DM subjects, wait-listed for Roux-en-Y gastric bypass (RYGB; n = 21) or laparoscopic sleeve gastrectomy (LSG; n = 8), received a 5-h mixed meal test before (T0), 15 days (T15), and 1 year after surgery (T365). Insulin sensitivity was assessed by the OGIS index and β-cell function by C-peptide analysis; fractional GGT (b-, s-, m-, and f-GGT) analysis was performed by gel-filtration chromatography.

Results

At T15, total GGT activity decreased by 40% after LSG (p = 0.007) but remained unchanged after RYGB. At T365, all patients showed a reduction in total GGT, in particular b-GGT (≥ 60%) and m-GGT (≥ 50%). In patients with biopsy-proven steatohepatitis (n = 10), total, b-, s-, and m-GGT fractions at T0 were significantly higher than in patients with low-grade steatosis (p = 0.016, 0.0003, and 0.005, respectively); at T365, there was a significant fall in total GGT as well as in each fraction in both groups. In a multiple regression model, b-GGT was the only fraction related to insulin sensitivity (p = 0.016; β coeff. = − 14.0) independently of BMI, fasting glucose, and triglycerides.

Conclusions

While GGT activity is generally associated with impaired glucose metabolism, fractional GGT analysis showed that the b-GGT fraction specifically and independently tracks with insulin resistance.

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Title: γ-Glutamyltransferase Fractions in Obese Subjects with Type 2 Diabetes: Relation to Insulin Sensitivity and Effects of Bariatric Surgery
Authors: Maria Franzini
Veronica Musetti
Daniela Guarino
Laura Caponi
Aldo Paolicchi
Michele Emdin
Ele Ferrannini
Monica Nannipieri
Publication date: 01-05-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 5/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-3017-7

At a glance: The STEP trials

Springer Medicine

γ-Glutamyltransferase Fractions in Obese Subjects with Type 2 Diabetes: Relation to Insulin Sensitivity and Effects of Bariatric Surgery

Abstract

Background/Objectives

Subjects/Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background/Objectives

Subjects/Methods

Results

Conclusions

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