Adipocyte size threshold matters: link with risk of type 2 diabetes and improved insulin resistance after gastric bypass.

Abstract

CONTEXT:

Adipocyte volume has been associated with insulin resistance and type 2 diabetes.

OBJECTIVE:

Our purpose was to identify an adipocyte volume threshold linked with increased insulin resistance risk, and to examine its association with insulin resistance improvement after bariatric surgery.

SETTING AND DESIGN:

We investigated two cohorts of Caucasian women, candidates for bariatric surgery, from two institutional centers in France (age 42.0 ± 11.5 years; body mass index, 47.6 ± 6.9 kg/m(2)) and Germany (age 41.3 ± 11.2 years; body mass index, 49.5 ± 8.1 kg/m(2)). 38% of the subjects had gastric bypass surgery and were followed for 6 months after the intervention. We defined a group of subjects with type 2 diabetes or at risk of type 2 diabetes (DRD) and investigated the relations between adipocyte volume and this status before and after surgery.

RESULTS:

In both cohorts, subjects with DRD presented enlarged adipocytes (France, P = 3×10(-4); Germany, P =3×10(-10)) and we were able to determine thresholds in each cohort above which diabetes risk was potentially increased (France: 1003±42 pL, Germany: 798±32 pL). Subjects above those adipocyte thresholds were less prone to disappearance of the DRD status after bypass surgery (France, risk ratio = 2.1, P = .024; Germany, risk ratio = 1.3, P = .05).

CONCLUSIONS:

We show in two cohorts of morbidly obese subjects that a specific adipocyte volume threshold may predict an increased risk for obesity-associated type 2 diabetes. However, this threshold might be established for each specific investigation site. Having a high adipocyte size is associated with a lower improvement of insulin resistance after bypass surgery in both cohorts.

• Authors: Aurelie Cotillard, Christine Poitou, Adriana Torcivia, Jean-Luc Bouillot, Arne Dietrich, Nora Klöting, Cécile Grégoire, Karine Lolmede, Matthias Blüher, Karine Clément
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 99 Issue 8 Pg. E1466-70 (Aug 2014) ISSN: 1945-7197 [Electronic] United States
• PMID: 24780048 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Topics

• Adipocytes (pathology)
• Adult
• Cell Size
• Cohort Studies
• Diabetes Mellitus, Type 2 (epidemiology)
• Female
• France (epidemiology)
• Gastric Bypass
• Germany (epidemiology)
• Humans
• Insulin Resistance
• Middle Aged
• Obesity, Morbid (pathology, surgery)
• Postoperative Period
• Risk Factors