Impairment of body mass reduction-associated activation of brown/beige adipose tissue in patients with type 2 diabetes mellitus

• Published in: International Journal of Obesity 2017-11, Vol.41 (11), p.1662-1668
• Main Authors: Rodovalho, S, Rachid, B, De-Lima-Junior, J C, van de Sande-Lee, S, Morari, J, Carvalho, H M, Amorim, B J, Tincani, A J, Chaim, E, Pareja, J C, Saad, M J, Folli, F, Ramos, C D, Geloneze, B, Velloso, L A
• Format: Article
• Language: English
• Subjects: 45/77; 59/57; 59/78; 692/163; 692/308; Activation; Adaptation, Physiological; Adipose tissue; Adipose Tissue, Beige - physiology; Adipose Tissue, Brown - physiology; Adipose tissues; Adult; AKT protein; Bariatric surgery; Bats; Biopsy; Body fat; Body mass; Body Mass Index; Care and treatment; Computed tomography; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - surgery; Epidemiology; Evaluation; Female; Fluorodeoxyglucose F18; Gastric Bypass; Gastrointestinal surgery; Health aspects; Health Promotion and Disease Prevention; Humans; Insulin; Insulin resistance; Insulin Resistance - physiology; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity; Obesity, Morbid - diagnostic imaging; Obesity, Morbid - metabolism; Obesity, Morbid - physiopathology; Obesity, Morbid - surgery; Observational studies; original-article; Patients; Phosphorylation; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography; Public Health; Radiopharmaceuticals; Reduction; Serine; Surgery; Tomography; Transcription; Treatment Outcome; Type 2 diabetes; Weight Loss - physiology; Young Adult
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2017.152

Backgrounds/Objectives: The activity of brown/beige adipose tissue (B/BAT) is inversely proportional to body adiposity. Studies have shown that obese subjects submitted to distinct approaches aimed at reducing body mass present an increase of B/BAT activation. However, it is unknown if this beneficial effect of body mass reduction applies to patients with type 2 diabetes mellitus. In this study, we evaluated the impact of massive body mass reduction obtained as a consequence of bariatric surgery in the cold-induced activation of B/BAT in obese non-diabetic (OND) and obese diabetic (OD) subjects. Subjects/Methods: This is an observational study. Fourteen OND, 14 OD and 11 subjects were included in the study. All obese subjects were submitted to Roux-in-Y gastric bypass and measurements were performed before and 8 months after surgery. B/BAT was evaluated by ( 18 F)-FDG-PET/CT scan and determination of signature transcript expression in specimens obtained in biopsies. Results: Before surgery, mean B/BAT activity and the expression of signature transcripts were similar between OND and OD groups. Eight months after surgery, body mass reduction was similar between the obese groups. Nevertheless, the activity of B/BAT was increased in OND and unchanged in OD subjects. This effect was correlated with a more pronounced improvement of insulin resistance, as evaluated by the hyperinsulinemic, euglycemic clamp, in OND subjects as compared with OD subjects. Conclusions: Body mass reduction has a more efficient effect to induce the activation of B/BAT in non-diabetic than in diabetic subjects. This effect is accompanied by more pronounced insulin sensitivity and serine 473 phosphorylation of Akt in B/BAT of non-diabetic than in diabetic subjects.