Postprandial adiponectin levels are associated with improvements in postprandial triglycerides after Roux-en-Y gastric bypass in type 2 diabetic patients.

BACKGROUND: Postprandial hypertrygliceridemia is a known factor for cardiovascular disease and is often observed in patients with type 2 diabetes mellitus (T2DM) and visceral adiposity. Adiponectin is a hormone with antiatherogenic and anti-inflammatory effects, which decreases in obesity and T2DM subjects. The weight loss induced by diet or bariatric surgery could be restoring adiponectin levels.

OBJECTIVE: The aim of the study was to evaluate the impact of weight loss induced by bariatric surgery, which could restore adiponectin and triglycerides (TG) levels in obese and diabetic patients.

METHODS: Ten patients with T2DM (BMI 39.3+2.44) were evaluated before and at 7 and 90 days after Roux-en-Y gastric bypass (RYGB). A meal test was performed and plasma insulin, glucagon-like peptide-1 (GLP-1), glucose, TG, and adiponectin levels were measured at fasting and at 30, 60, 90, and 120 min postprandial.

RESULTS: Seven days after surgery, significant reductions in the insulin resistance were observed, while TG and adiponectin levels remained unchanged during the meal test. Ninety days after surgery, TG and glucose levels decreased significantly at fasting, and postprandial, adiponectin, GLP-1, and insulin curves increased significantly after meal ingestion. Both changes in the area under the curve (AUC) of adiponectin correlated with changes in the AUC of TG (R=-0.64, P=0.003) and changes in AUC of adiponectin correlated with changes in total fat mass. No correlation was found between changes in insulin, GLP-1, and TG levels.

CONCLUSIONS: The adiponectin levels may be involved in the mechanism responsible for high TG levels in obese and diabetic patients. These abnormalities can be reversed by RYGB.