Immunological Evaluation of Patients With Type 2 Diabetes Mellitus Submitted to Metabolic Surgery

Borges, Marisa de Carvalho; Terra, Guilherme Azevedo; Takeuti, Tharsus Dias; Ribeiro, Betânia Maria; Silva, Alex Augusto; Terra-Júnior, Juverson Alves; Rodrigues-Júnior, Virmondes; Crema, Eduardo

doi:10.1590/s0102-6720201500040012

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…An alternative hypothesis involves rapid delivery of ingested nutrients not absorbed by the distal intestine, which would increase the secretion of GLP-1 4 , 27 . Although the mechanism for this effect is not completely known yet, it can be directly related with the change in the flow of nutrients, despite any effect in the secretion of known or hypothetical intestinal hormones.…”

Section: Resultsmentioning

confidence: 99%

The Role of the Sleeve Gastrectomy and the Management of Type 2 Diabetes

Fuchs¹,

Loureiro²,

Both

et al. 2017

ABCD, arq. bras. cir. dig.

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Background : Currently, bariatric surgery has promoted weight loss and improved glycemic control in obese patients through different techniques, including vertical sleeve gastrectomy. Aim : Present and update the different vertical sleeve gastrectomy ways of action, both in the treatment of obesity and diabetes, approaching its potential effect on gastrointestinal physiology, as well as the benefits achieved by this manipulation. Methods : Pubmed database search was used crossing the headings: obesity, type 2 diabetes and sleeve gastrectomy. Results : Published data have shown that short-term weight loss tends to be higher in patients undergoing vertical sleeve gastrectomy compared to Roux-en-Y gastric bypass. In relation to glycemic control, the procedure demonstrated remission of diabetes in up to 60% after one year of surgery. After three years, however, differences in remission rate between surgical and clinical group was not observed, questioning the durability of the technical in a long-term. Conclusion : Despite showing good results, both in the weight loss and co-morbidities, conflicting results reinforce the need for more studies to prove the efficiency of the vertical sleeve gastrectomy as well as to understand its action about the molecular mechanisms involved in the disease.

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Section: Resultsmentioning

confidence: 99%

The Role of the Sleeve Gastrectomy and the Management of Type 2 Diabetes

Fuchs¹,

Loureiro²,

Both

et al. 2017

ABCD, arq. bras. cir. dig.

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“…Sigalet et al (36) also revealed that pediatric patients with active Crohn's disease presented significantly lower postprandial GLP-2 levels than healthy controls. Although the inflammation is supposed to be much more intense in inflammatory bowel diseases, obesity and T2D are also associated with a low-grade chronic inflammatory state (37)(38)(39)(40) . In fact, the discrepancy in CRP levels among the groups along with the differences in the GLP-2 levels observed in the present study tend to signal that this inflammatory state may also play a significant role in this mechanism.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Levels of C-Reactive Protein, GLP-1 and GLP-2 Among Individuals With Diabetes, Morbid Obesity and Healthy Controls: An Exploratory Study

Cazzo

Pareja

Chaim

et al. 2018

Arq. Gastroenterol.

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-Background -The glucagon-like peptides 1 and 2 (GLP-1/GLP-2) are gut hormones that may directly affect the glucose homeostasis and their activity seems to be significantly affected by chronic inflammation. Objective -To evaluate the postprandial levels of glucagon-like peptides 1 and 2 (GLP-1/GLP-2), C-reactive protein (CRP), and the postprandial glucose and insulin levels among individuals with obesity, type 2 diabetes, and healthy controls. Methods -An exploratory cross-sectional study, which involved individuals awaiting for bariatric/metabolic surgery and healthy controls. Postprandial levels of GLP-1, GLP-2, glucose, and insulin were obtained after a standard meal tolerance test. Inflammation was assessed by means of CRP. Results -There were 30 individuals enrolled in the study, divided into three groups: non-diabetic with morbid obesity (NDO; n=11 individuals), diabetic with mild obesity (T2D; n=12 individuals), and healthy controls (C; n=7 individuals). The mean CRP levels were significantly higher in the NDO group (6.6±4.7 mg/dL) than in the T2D (3.3±2.2 mg/dL) and C groups (2.5±3.2 mg/dL) (P=0.038). The GLP-1 levels following standard meal tolerance test and the area under the curve of GLP-1 did not differ among the three groups. The GLP-2 levels were significantly lower in the NDO and T2D than in the C group following standard meal tolerance test at all the times evaluated. The area under the curve of the GLP-2 was significantly lower in the NDO and T2D groups than in the C group (P=0.05 and P=0.01, respectively). Conclusion -GLP-2 levels were impaired in the individuals with obesity and diabetes. This mechanism seems to be enrolled in preventing the worsening of the glucose homeostasis in these individuals. HEADINGS -Glucagon-like peptide 1. Glucagon-like peptide 2. Diabetes mellitus. Obesity. Insulin resistance. Incretins.

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“…Thiazolidinediones improve insulin sensitivity while sulfonylureas stimulate the secretion of this hormone [11] . In contrast, incretins (hormones produced by the gastrointestinal tract and released into the gut in response to food intake) also potentiate insulin secretion and sensitivity in their target tissues by playing an important role in pancreatic β-cell modulation [12] . However, this hormone is rapidly degraded by an enzyme called Dipeptidil Peptidase (DPP4).…”

Section: Obesity and Metabolic Syndromementioning

confidence: 99%

Metabolic Alterations Present in Obesity and Correlation with Non-Alcoholic Fatty Liver Disease (NAFLD)

Franco

Biochemistry²,

Porto

2019

Journal of Gastroenterology and Hepatology Research

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Currently in the world, thousands of people are somewhat overweight. Obesity, mainly characterized by the accumulation of fat in adipose tissue can cause various damages in the body, incluind Metabolic Syndrome. There is a high correlation between patients with this syndrome and those with Non-Alcoholic Fatty Liver Disease (NAFLD), being defined as the increase of the deposition of lipids in the liver in the absence of excessive consumption of alcohol. Excess intake of saturated fatty acids, increased free fatty acids derived from white adipose tissue lipolysis, reduced β-oxidation along with an increase in de novo lipogenesis and decreased synthesis or secretion of VLDL in hepatocytes contribute to the Hepatic steatosis. The treatment for these pathologies is initially based on diet changes and physical activity practice. In addition, there are still some classes of medicines available to treat the accumulation of fat in the liver as well as decrease insulin resistance. Studies still seek to find specific medicines for the treatment of NAFLD, therefore, the most effective method continues to be prevention, through an improvement in the quality of life, related to a balanced diet and the practice of regular physical activity.

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Immunological Evaluation of Patients With Type 2 Diabetes Mellitus Submitted to Metabolic Surgery

Cited by 8 publications

References 18 publications

The Role of the Sleeve Gastrectomy and the Management of Type 2 Diabetes

The Role of the Sleeve Gastrectomy and the Management of Type 2 Diabetes

Comparison of the Levels of C-Reactive Protein, GLP-1 and GLP-2 Among Individuals With Diabetes, Morbid Obesity and Healthy Controls: An Exploratory Study

Metabolic Alterations Present in Obesity and Correlation with Non-Alcoholic Fatty Liver Disease (NAFLD)

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