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γ-Glutamyltransferase Fractions in Obese Subjects with Type 2 Diabetes: Relation to Insulin Sensitivity and Effects of Bariatric Surgery.
Franzini, Maria; Musetti, Veronica; Guarino, Daniela; Caponi, Laura; Paolicchi, Aldo; Emdin, Michele; Ferrannini, Ele; Nannipieri, Monica.
Afiliación
  • Franzini M; Department of Translational Research, University of Pisa, Pisa, Italy.
  • Musetti V; Department of Translational Research, University of Pisa, Pisa, Italy.
  • Guarino D; Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 8, 56126, Pisa, Italy.
  • Caponi L; Department of Translational Research, University of Pisa, Pisa, Italy.
  • Paolicchi A; Department of Translational Research, University of Pisa, Pisa, Italy.
  • Emdin M; Sant'Anna School of Advanced Study - Pisa and CNR Institute of Clinical Physiology, Pisa, Italy.
  • Ferrannini E; Fondazione Toscana G. Monasterio, Pisa, Italy.
  • Nannipieri M; CNR Institute of Clinical Physiology, Pisa, Italy.
Obes Surg ; 28(5): 1363-1371, 2018 05.
Article en En | MEDLINE | ID: mdl-29170860
ABSTRACT
BACKGROUND/

OBJECTIVES:

Gamma-glutamyltranspeptidase (GGT) levels are an independent risk marker for the development of type 2 diabetes (T2DM). We investigated the relationship between the newly identified serum GGT fractions and glucose metabolism in obese subjects before and after bariatric surgery. SUBJECTS/

METHODS:

Twenty-nine T2DM subjects, wait-listed for Roux-en-Y gastric bypass (RYGB; n = 21) or laparoscopic sleeve gastrectomy (LSG; n = 8), received a 5-h mixed meal test before (T0), 15 days (T15), and 1 year after surgery (T365). Insulin sensitivity was assessed by the OGIS index and ß-cell function by C-peptide analysis; fractional GGT (b-, s-, m-, and f-GGT) analysis was performed by gel-filtration chromatography.

RESULTS:

At T15, total GGT activity decreased by 40% after LSG (p = 0.007) but remained unchanged after RYGB. At T365, all patients showed a reduction in total GGT, in particular b-GGT (≥ 60%) and m-GGT (≥ 50%). In patients with biopsy-proven steatohepatitis (n = 10), total, b-, s-, and m-GGT fractions at T0 were significantly higher than in patients with low-grade steatosis (p = 0.016, 0.0003, and 0.005, respectively); at T365, there was a significant fall in total GGT as well as in each fraction in both groups. In a multiple regression model, b-GGT was the only fraction related to insulin sensitivity (p = 0.016; ß coeff. = - 14.0) independently of BMI, fasting glucose, and triglycerides.

CONCLUSIONS:

While GGT activity is generally associated with impaired glucose metabolism, fractional GGT analysis showed that the b-GGT fraction specifically and independently tracks with insulin resistance.
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Texto completo: 1 Colección: 01-internacional Asunto principal: Obesidad Mórbida / Resistencia a la Insulina / Diabetes Mellitus Tipo 2 / Cirugía Bariátrica / Gamma-Glutamiltransferasa Tipo de estudio: Diagnostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2018 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Asunto principal: Obesidad Mórbida / Resistencia a la Insulina / Diabetes Mellitus Tipo 2 / Cirugía Bariátrica / Gamma-Glutamiltransferasa Tipo de estudio: Diagnostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Obes Surg Asunto de la revista: METABOLISMO Año: 2018 Tipo del documento: Article País de afiliación: Italia