Role of adipose tissue GLP-1R expression in metabolic improvement after bariatric surgery in patients with type 2 diabetes

Abstract

We aimed to explore the relationship between GLP-1 receptor ( GLP-1R ) expression in adipose tissue (AT) and incretin secretion, glucose homeostasis and weight loss, in patients with morbid obesity and type 2 diabetes undergoing bariatric surgery. RNA was extracted from subcutaneous (SAT) and visceral (VAT) AT biopsies from 40 patients randomized to metabolic gastric bypass, sleeve gastrectomy or greater curvature plication. Biochemical parameters, fasting plasma insulin, glucagon and area under the curve (AUC) of GLP-1 following a standard meal test were determined before and 1 year after bariatric surgery. GLP-1R expression was higher in VAT than in SAT. GLP-1R expression in VAT correlated with weight (r = −0.453, p = 0.008), waist circumference (r = −0.494, p = 0.004), plasma insulin (r = −0.466, p = 0.007), and systolic blood pressure (BP) (r = −0.410, p = 0.018). At 1 year, GLP-1R expression in VAT was negatively associated with diastolic BP (r = −0.361, p = 0.039) and, following metabolic gastric bypass, with the increase of GLP-1 AUC, (R 2 = 0.46, p = 0.038). Finally, GLP-1R in AT was similar independently of diabetes outcomes and was not associated with weight loss after surgery. Thus, GLP-1R expression in AT is of limited value to predict incretin response and does not play a role in metabolic outcomes after bariatric surgery.

Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease

“…Liraglutide has also been shown to reduce total adiposity, and specifically visceral fat mass (582,583). While initially described as being devoid of GLP-1 receptors (584), it has now been confirmed that adipocytes express the GLP-1 receptor (585,586). Adipose tissue may therefore be an additional target for GLP-1 receptor agonists to promote adipose remodeling by unknown mechanisms.…”

Achieving blood pressure targets and antihypertensive effects through metabolic surgery in type 2 diabetes patients with hypertension

“…Accordingly, the factors affecting metabolic surgery mediated antihypertension need to be identified. Some studies suggest that gut hormones may be a potential target for the treatment of hypertension because metabolic surgery increases GLP‐1 secretion 19 . Our previous research showed that metabolic surgery significantly antagonised the activation of the sympathetic nerve system in both human and experimental hypertensive models 20 .…”

Impact of Laparoscopic Sleeve Gastrectomy on Obese Type 2 Diabetic Patients and Role of Gut Hormones Peptide Tyrosine Tyrosine and Glucagon Like Peptide 1on Remission of Diabetes

“…Ejarque, et al showed that 1 year after surgery, the increase in the area under curve (AUC) for GLP-1 was significantly higher in the RYGB group than in SG. Less clear is the extent to which GLP-1 changes are responsible for T2DM remission [23].…”