Differential Influences of Gastric Bypass and Sleeve Gastrectomy on Plasma Nesfatin-1 and Obestatin Levels in Patients with Type 2 Diabetes Mellitus

Wei-Jei      Lee; Chih-Yen      Chen; Kong-Han      Ser; Keong      Chong; Shu-Chun      Chen; Pui-Ching      Lee; You-Di      Liao; Shou-Dong      Lee

doi:10.2174/13816128113198880010

Abstract

Objective: The mechanisms by which bariatric surgeries, including gastric bypass (GB) and sleeve gastrectomy (SG), achieve remission of type 2 diabetes mellitus (T2DM) and sustained weight reduction are unknown. We hypothesized that the novel anorexic hormone nesfatin-1 and another new hormone obestatin might contribute to the marked improvement in glycemic homeostasis and weight loss in diabetics after GB and SG.

Methods: A hospital-based, prospective study was conducted. Overnight fasting plasma concentrations of nesfatin-1 and obestatin were analyzed in T2DM patients before surgery, and at 3 and 12 months after laparoscopic GB (n =12) and SG (n = 6).

Results: At 12 months, reductions of body mass index (BMI), fasting blood glucose, and glycated hemoglobin were similar between GB and SG groups (P all > 0.05). Plasma nesfatin-1 levels in patients undergoing GB or SG significantly decreased after surgeries (P both < 0.05). In contrast, plasma obestatin concentrations significantly increased in patients after SG (P < 0.05) but without any alteration after GB. The alterations of plasma nesfatin-1 were significantly and negatively associated with the reduction of fasting blood glucose (P < 0.05) at 12 months after GB and SG. In the SG group, the reduction of nesfatin-1 significantly and positively correlated with the decrease of BMI (P < 0.05).

Conclusions: GB and SG produce differential influences with regards to circulating nesfatin-1 and obestatin levels in non-morbidly obese, T2DM patients. Circulating nesfatin-1 may modulate glucose homeostasis in two surgical procedures, and participate in regulating body weight in SG.

Keywords: Bariatric surgery, diabetes mellitus, gastric bypass, nesfatin-1, obestatin, sleeve gastrectomy.

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