Dataset Information

Metabolomic Profiles Predict Diabetes Remission after Bariatric Surgery.

ABSTRACT:

Background

Amino acid metabolites (AAMs) have been linked to glucose homeostasis and type 2 diabetes (T2D). We investigated whether (1) baseline AAMs predict T2D remission 12 months after bariatric surgery and (2) whether AAMs are superior for predicting T2D remission postoperatively compared with existing prediction models.

Methods

Among 24 participants undergoing bariatric surgery, 16 diabetes-related AAMs were quantified at baseline and postoperative 3 and 12 months. Existing prediction models included the ABCD, DiaRem, and IMS models.

Results

Baseline L-dihydroxyphenylalanine (L-DOPA) (areas under receiver operating characteristic curves (AUROC), 0.92; 95% confidence interval (CI), 0.75 to 1.00) and 3-hydroxyanthranilic acid (3-HAA) (AUROC, 0.85; 95% CI, 0.67 to 1.00) better predicted T2D remission 12 months postoperatively than the ABCD model (AUROC, 0.81; 95% CI, 0.54 to 1.00), which presented the highest AUROC value among the three models. The superior prognostic performance of L-DOPA (AUROC at 3 months, 0.97; 95% CI, 0.91 to 1.00) and 3-HAA (AUROC at 3 months, 0.86; 95% CI, 0.63 to 1.00) continued until 3 months postoperatively.

Conclusions

The AAM profile predicts T2D remission after bariatric surgery more effectively than the existing prediction models.

SUBMITTER: Ha J

PROVIDER: S-EPMC7760750 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Metabolomic Profiles Predict Diabetes Remission after Bariatric Surgery.

Ha Jane J Jang Mi M Kwon Yeongkeun Y Park Young Suk YS Park Do Joong DJ Lee Joo-Ho JH Lee Hyuk-Joon HJ Ha Tae Kyung TK Kim Yong-Jin YJ Han Sang-Moon SM Han Sang-Uk SU Heo Yoonseok Y Park Sungsoo S

Journal of clinical medicine 20201201 12

<h4>Background</h4>Amino acid metabolites (AAMs) have been linked to glucose homeostasis and type 2 diabetes (T2D). We investigated whether (1) baseline AAMs predict T2D remission 12 months after bariatric surgery and (2) whether AAMs are superior for predicting T2D remission postoperatively compared with existing prediction models.<h4>Methods</h4>Among 24 participants undergoing bariatric surgery, 16 diabetes-related AAMs were quantified at baseline and postoperative 3 and 12 months. Existing p ...[more]

PMID: 33271740

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Project description:Rationale & objectiveThe association between bariatric surgery, type 2 diabetes, and chronic kidney disease (CKD) is poorly understood. We studied whether remission of type 2 diabetes induced by bariatric surgery influences markers of kidney disease, if CKD is associated with remission of diabetes after bariatric surgery, and if baseline levels of gut hormones and peptides modify these associations.Study designProspective observational study.Study participants737 bariatric surgery patients with type 2 diabetes who participated in a multicenter cohort study for up to 5 years.PredictorsDemographics, blood pressure, medications, type of bariatric surgery, anthropometrics, markers of kidney disease, and circulating levels of gut hormones and peptides.OutcomesEstimated glomerular filtration rate (eGFR), urinary albumin excretion, prognostic risk for CKD, and remission of diabetes.Analytical approachLinear mixed models for eGFR; generalized linear mixed models with logit link for albuminuria, prognostic risk for CKD, and diabetes remission.ResultsRemission of diabetes at 5 years post-bariatric surgery was not independently associated with eGFR but was associated with lower risk for moderate/severe increase in albuminuria (risk ratio, 0.66; 95% CI, 0.48-0.90) and stabilization in prognostic risk for CKD. These findings were modified by baseline ghrelin level. Lower preoperative eGFR and greater prognostic risk for CKD were independently associated with reduced likelihood of diabetes remission. The association with preoperative GFR was modified by C-peptide level. Higher baseline circulating ghrelin level was independently associated with a lower prognostic risk for CKD.LimitationsA minority of participants had baseline CKD; lack of comparison group; no information on duration of diabetes, other clinical end points, or kidney biopsy results.ConclusionsRemission of type 2 diabetes 5 years after bariatric surgery was associated with improvements in albuminuria and stabilized prognostic risk for CKD, but not with eGFR. Lower kidney function and greater prognostic risk at the time of bariatric surgery was linked to a lower likelihood of diabetes remission. These results highlight the need to identify the mechanisms through which bariatric surgery may delay the long-term progression of CKD in type 2 diabetes.

Dataset Information

Metabolomic Profiles Predict Diabetes Remission after Bariatric Surgery.

Background

Methods

Results

Conclusions

Publications

Metabolomic Profiles Predict Diabetes Remission after Bariatric Surgery.

Similar Datasets

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