Thermogenesis and reduced lipid synthesis: one-anastomosis gastric bypass bariatric surgery 6-mo follow-ups in adipose tissue health context for type 2 diabetes.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

One-anastomosis gastric bypass (OAGB) represents a novel less invasive bariatric surgery technique that can significantly improve systemic metabolism and adipose tissue health in patients with type 2 diabetes mellitus (T2DM). Previously, we demonstrated that T2DM impairs proliferation and differentiation of adipose tissue progenitors. Obese patients with T2DM ( n = 10) underwent clinical examination and subcutaneous fat biopsy during bariatric surgery and in 6 mo. Adipose-derived stem cells (ADSCs) were isolated by enzymatic method. Cell proliferation was analyzed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay and immunocytochemistry. Adipogenesis and thermogenesis were assessed by confocal microscopy. Adipocyte metabolism was estimated by radioisotope tracing. Western blotting was used to quantify protein expression. Median weight loss after OAGB was 40 kg. OAGB resolved hyperinsulinemia and stimulated insulin sensitivity with changes in homeostatic model assessment of insulin resistance and M-index up to twofold. Bariatric surgery significantly influenced properties of ADSC adipocytes: there were an increase in ADSC proliferation, decrease in white adipogenesis, activation of white and beige adipocyte lipid droplet fragmentation, activation of thermogenesis, and inhibition of lipogenesis. OAGB promotes weight loss and insulin sensitivity and changes

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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