Serum levels of osteopontin predict diabetes remission after bariatric surgery - 12/10/18

Doi : 10.1016/j.diabet.2018.09.007

F. Carbone ^a,^⁎ , G. Adami ^b, L. Liberale ^a,^c, A. Bonaventura ^a, M. Bertolotto ^a, G. Andraghetti ^b, N. Scopinaro ^d, G.B. Camerini ^d, F.S. Papadia ^d, R. Cordera ^e, F. Dallegri ^a,^f, F. Montecucco ^a,^f,^g
^a First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
^b Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
^c Centre for Molecular Cardiology, University of Zürich, 12 Wagistrasse, 8952 Schlieren, Switzerland
^d Department of Surgery, University of Genoa, 10 Largo Benzi, 16132 Genoa, Italy
^e Diabetology Unit, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
^f First Clinic of Internal Medicine, Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
^g Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 viale Benedetto XV, 16132 Genoa, Italy

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 12 October 2018
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Abstract

Aim

Bariatric surgery has been shown to effectively improve glycaemic control in morbidly obese subjects. However, the molecular bases of this association are still elusive and may act independently of weight loss. Here, our retrospective study has investigated the inflammatory molecule osteopontin (OPN) as a potential predictor of type 2 diabetes mellitus (T2DM) remission.

Methods

Baseline serum levels of OPN were analyzed in 41 T2DM patients who underwent bariatric surgery. Anthropometric measures and biochemical variables, including insulin sensitivity indices (HOMA2), were assessed at baseline and at 1 and 3 years after surgery.

Results

At baseline, patients who experienced T2DM remission had increased waist circumference, body weight and BMI, and higher serum OPN, compared with non-remitters. Patients with and without T2DM remission improved their lipid and glucose profiles, although insulin resistance indices were only improved in the T2DM remission group. In the overall cohort of both T2DM remission and non-remission patients, baseline circulating levels of OPN significantly correlated with reductions of body weight and BMI over time, and insulin sensitivity improved as well. However, only the HOMA2-%S remained independently associated with serum OPN on multivariate linear regression analysis (B: 0.227, 95% CI: 0.067–0.387, β = 0.831; P = 0.010). Baseline values of OPN predicted 3-year T2DM remission independently of body weight loss, lower BMI and duration of diabetes (OR: 1.046, 95% CI: 1.004–1.090; P = 0.033).

Conclusion

Although larger studies are still needed to confirm our preliminary results, pre-operative OPN serum levels might be useful for predicting 3-year T2DM remission independently of weight loss in patients undergoing bariatric surgery.

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Keywords : Bariatric surgery, HOMA2, Obesity, Osteopontin, Type 2 diabetes mellitus