BACKGROUND Bariatric surgery is an efficient strategy for body weight and type 2 diabetes mellitus(T2 DM) management. Abnormal lipid deposition in visceral organs,especially the pancreas and liver, might cause beta-ce...BACKGROUND Bariatric surgery is an efficient strategy for body weight and type 2 diabetes mellitus(T2 DM) management. Abnormal lipid deposition in visceral organs,especially the pancreas and liver, might cause beta-cell dysfunction and insulin resistance. Extracellular matrix(ECM) remodeling allows adipose expansion, and matrix metalloproteinases(MMPs) play essential roles in ECM construction.MMP-2 and MMP-9 are the substrates of MMP-7. Different studies have reported that MMP-2,-7, and-9 increase in patients with obesity and metabolic syndromes or T2 DM and are considered biomarkers in obesity and hyperglycemia patients.AIMTo prospectively investigate whether MMP-2, MMP-7, and MMP-9 differ after two bariatric surgeries: Gastric bypass(GB) and sleeve gastrectomy(SG).METHODS We performed GB in 23 and SG in 19 obese patients with T2 DM. We measured body weight, waist circumference, body mass index(BMI), and serum concentrations of total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood sugar(FBS),hemoglobin A1 c(Hb A1 c), C-peptide, homeostasis model assessments of insulin resistance, and MMP-2, MMP-7, and MMP-9 levels at baseline and at 3, 12, and 24 mo post-operation.RESULTS Twenty-three patients aged 44.7 ± 9.7 years underwent GB, and 19 patients aged40.1 ± 9.1 years underwent SG. In the GB group, BMI decreased from 30.3 ± 3.4 to24.4 ± 2.4 kg/m2, Hb A1 c decreased from 9.2% ± 1.5% to 6.7% ± 1.4%, and FBS decreased from 171.6 ± 65.0 mg/d L to 117.7 ± 37.5 mg/d L 2 years post-operation(P < 0.001). However, the MMP-2, MMP-7, and MMP-9 levels pre-and post-GB were similar even 2 years post-operation(P = 0.107, 0.258, and 0.466,respectively). The SG group revealed similar results: BMI decreased from 36.2 ±5.1 to 26.9 ± 4.7 kg/m2, Hb A1 c decreased from 7.9% ± 1.7% to 5.8% ± 0.6%, and FBS decreased from 138.3 ± 55.6 mg/d L to 95.1 ± 3.1 mg/d L(P < 0.001). The serum MMP-2,-7, and-9 levels pre-and post-SG were not different(P = 0.083,0.869, and 0.1, respectively).CONCLUSION Improvements in obesity and T2 DM induced by bariatric surgery might be the result of MMP-2,-7, or-9 independent pathways.展开更多
The prevalence of overweight and obesity has increased worldwide.Obesity is a well-known risk factor of type 2 diabetes mellitus and cardiovascular disease and raises public health concerns.Many dietary guidelines enc...The prevalence of overweight and obesity has increased worldwide.Obesity is a well-known risk factor of type 2 diabetes mellitus and cardiovascular disease and raises public health concerns.Many dietary guidelines encourage the replacement of refined grains with whole grains(WGs)to enhance body weight management.Current evidence regarding interrelationships among WGs,body weight,and gut microbiota is limited and inconclusive.In this editorial,we comment on the article by Roager et al published in the recent issue of the Gut 2019;68(1):83-93.In the study,obese patients(25<body mass index<35 kg/m2)were randomly assigned to receive two 8-wk dietary controlling periods with WGs and refined grain-rich diet.The results showed significantly decreased body weight in the WG group.Either the composition of gut microbiota or short-chain fatty acids,the leading end product of fermentation of non-digestible carbohydrate by gut microbiota,did not differ between the two groups.The study highly indicated that a WG-rich diet reduced body weight independent of gut microbiota.We then raised some plausible mechanisms of how WGs might influence body weight and demonstrated more literature in line with WGs enhance body weight control through a microbiota-independent pathway.Possible mechanisms include:(1)The abundant dietary fiber contents of WGs increase satiety,satiation,energy excretion from stool,and energy expenditure simultaneously decreasing energy absorption and fat storage;(2)The plentiful amount of polyphenols of WGs improve energy expenditure by hampering adipocyte maturation and function;(3)The sufficient magnesium and zinc of WGs guarantee lean body mass growth and decrease fat mass;(4)The effect of WGs on brown adipose tissue is a key component of non-shivering thermogenesis;and(5)The increase of adiponectin by WGs enhances glucose utilization,lipid oxidation,and energy expenditure.展开更多
基金Supported by grants from MinSheng General Hospital,Taoyuan,Far Eastern Memorial Hospital-National Yang-Ming University Joint Research Program,No. 105DN15,No. 106DN15,and No. 107DN14 to Lee TH and Chen CY。
文摘BACKGROUND Bariatric surgery is an efficient strategy for body weight and type 2 diabetes mellitus(T2 DM) management. Abnormal lipid deposition in visceral organs,especially the pancreas and liver, might cause beta-cell dysfunction and insulin resistance. Extracellular matrix(ECM) remodeling allows adipose expansion, and matrix metalloproteinases(MMPs) play essential roles in ECM construction.MMP-2 and MMP-9 are the substrates of MMP-7. Different studies have reported that MMP-2,-7, and-9 increase in patients with obesity and metabolic syndromes or T2 DM and are considered biomarkers in obesity and hyperglycemia patients.AIMTo prospectively investigate whether MMP-2, MMP-7, and MMP-9 differ after two bariatric surgeries: Gastric bypass(GB) and sleeve gastrectomy(SG).METHODS We performed GB in 23 and SG in 19 obese patients with T2 DM. We measured body weight, waist circumference, body mass index(BMI), and serum concentrations of total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood sugar(FBS),hemoglobin A1 c(Hb A1 c), C-peptide, homeostasis model assessments of insulin resistance, and MMP-2, MMP-7, and MMP-9 levels at baseline and at 3, 12, and 24 mo post-operation.RESULTS Twenty-three patients aged 44.7 ± 9.7 years underwent GB, and 19 patients aged40.1 ± 9.1 years underwent SG. In the GB group, BMI decreased from 30.3 ± 3.4 to24.4 ± 2.4 kg/m2, Hb A1 c decreased from 9.2% ± 1.5% to 6.7% ± 1.4%, and FBS decreased from 171.6 ± 65.0 mg/d L to 117.7 ± 37.5 mg/d L 2 years post-operation(P < 0.001). However, the MMP-2, MMP-7, and MMP-9 levels pre-and post-GB were similar even 2 years post-operation(P = 0.107, 0.258, and 0.466,respectively). The SG group revealed similar results: BMI decreased from 36.2 ±5.1 to 26.9 ± 4.7 kg/m2, Hb A1 c decreased from 7.9% ± 1.7% to 5.8% ± 0.6%, and FBS decreased from 138.3 ± 55.6 mg/d L to 95.1 ± 3.1 mg/d L(P < 0.001). The serum MMP-2,-7, and-9 levels pre-and post-SG were not different(P = 0.083,0.869, and 0.1, respectively).CONCLUSION Improvements in obesity and T2 DM induced by bariatric surgery might be the result of MMP-2,-7, or-9 independent pathways.
文摘The prevalence of overweight and obesity has increased worldwide.Obesity is a well-known risk factor of type 2 diabetes mellitus and cardiovascular disease and raises public health concerns.Many dietary guidelines encourage the replacement of refined grains with whole grains(WGs)to enhance body weight management.Current evidence regarding interrelationships among WGs,body weight,and gut microbiota is limited and inconclusive.In this editorial,we comment on the article by Roager et al published in the recent issue of the Gut 2019;68(1):83-93.In the study,obese patients(25<body mass index<35 kg/m2)were randomly assigned to receive two 8-wk dietary controlling periods with WGs and refined grain-rich diet.The results showed significantly decreased body weight in the WG group.Either the composition of gut microbiota or short-chain fatty acids,the leading end product of fermentation of non-digestible carbohydrate by gut microbiota,did not differ between the two groups.The study highly indicated that a WG-rich diet reduced body weight independent of gut microbiota.We then raised some plausible mechanisms of how WGs might influence body weight and demonstrated more literature in line with WGs enhance body weight control through a microbiota-independent pathway.Possible mechanisms include:(1)The abundant dietary fiber contents of WGs increase satiety,satiation,energy excretion from stool,and energy expenditure simultaneously decreasing energy absorption and fat storage;(2)The plentiful amount of polyphenols of WGs improve energy expenditure by hampering adipocyte maturation and function;(3)The sufficient magnesium and zinc of WGs guarantee lean body mass growth and decrease fat mass;(4)The effect of WGs on brown adipose tissue is a key component of non-shivering thermogenesis;and(5)The increase of adiponectin by WGs enhances glucose utilization,lipid oxidation,and energy expenditure.
