Differential influences of gastric bypass and sleeve gastrectomy on plasma nesfatin-1 and obestatin levels in patients with type 2 diabetes mellitus

• Published in: Current pharmaceutical design Vol. 19; no. 32; p. 5830
• Main Authors: Lee, Wei-Jei, Chen, Chih-Yen, Ser, Kong-Han, Chong, Keong, Chen, Shu-Chun, Lee, Pui-Ching, Liao, You-Di, Lee, Shou-Dong
• Format: Journal Article
• Language: English
• Published: United Arab Emirates 01.10.2013
• Subjects: Adult; Blood Glucose - metabolism; Calcium-Binding Proteins - blood; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - surgery; DNA-Binding Proteins - blood; Female; Follow-Up Studies; Gastrectomy - methods; Gastric Bypass - methods; Ghrelin - blood; Humans; Laparoscopy - methods; Male; Middle Aged; Nerve Tissue Proteins - blood; Prospective Studies; Time Factors; Treatment Outcome; Weight Loss
• ISSN: 1873-4286
• DOI: 10.2174/13816128113198880010

The mechanisms by which bariatric surgeries, including gastric bypass (GB) and sleeve gastrectomy (SG), achieve remission of type 2 diabetes mellitus (T2DM) and sustained weight reduction are unknown. We hypothesized that the novel anorexic hormone nesfatin-1 and another new hormone obestatin might contribute to the marked improvement in glycemic homeostasis and weight loss in diabetics after GB and SG. A hospital-based, prospective study was conducted. Overnight fasting plasma concentrations of nesfatin-1 and obestatin were analyzed in T2DM patients before surgery, and at 3 and 12 months after laparoscopic GB (n =12) and SG (n = 6). At 12 months, reductions of body mass index (BMI), fasting blood glucose, and glycated hemoglobin were similar between GB and SG groups (P all > 0.05). Plasma nesfatin-1 levels in patients undergoing GB or SG significantly decreased after surgeries (P both < 0.05). In contrast, plasma obestatin concentrations significantly increased in patients after SG (P < 0.05) but without any alteration after GB. The alterations of plasma nesfatin-1 were significantly and negatively associated with the reduction of fasting blood glucose (P <0.05) at 12 months after GB and SG. In the SG group, the reduction of nesfatin-1 significantly and positively correlated with the decrease of BMI (P < 0.05). GB and SG produce differential influences with regards to circulating nesfatin-1 and obestatin levels in non-morbidly obese, T2DM patients. Circulating nesfatin-1 may modulate glucose homeostasis in two surgical procedures, and participate in regulating body weight in SG.