A multi-center study on glucometabolic response to bariatric surgery for different subtypes of obesity

Yao Liu; Chunjun Sheng; Wenhuan Feng; Fang Sun; Jingjing Zhang; Jingjing Zhang; Ying Chen; Lili Su; Jia Liu; Lei Du; Xuyang Jia; Hui You; Xiu Huang; Shandong Wu; Shandong Wu; Shandong Wu; Ziwei Lin; Shen Qu

doi:10.3389/fendo.2022.989202

Frontiers in Endocrinology (Nov 2022)

A multi-center study on glucometabolic response to bariatric surgery for different subtypes of obesity

Yao Liu,
Chunjun Sheng,
Wenhuan Feng,
Fang Sun,
Jingjing Zhang,
Jingjing Zhang,
Ying Chen,
Lili Su,
Jia Liu,
Lei Du,
Xuyang Jia,
Hui You,
Xiu Huang,
Shandong Wu,
Shandong Wu,
Shandong Wu,
Ziwei Lin,
Shen Qu

Affiliations

Yao Liu: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Chunjun Sheng: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Wenhuan Feng: Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China
Fang Sun: Department of Hypertension and Endocrinology, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing, China
Jingjing Zhang: National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Jingjing Zhang: Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
Ying Chen: Ministry of Education, Key Laboratory of Metabolism and Molecular Medicine, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
Lili Su: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Jia Liu: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Lei Du: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Xuyang Jia: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Hui You: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Xiu Huang: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Shandong Wu: Department of Radiology, Department of Biomedical Informatics, Department of Bioengineering, Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, United States
Shandong Wu: Department of Biomedical Informatics, Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, United States
Shandong Wu: Department of Bioengineering, Intelligent Systems Program, University of Pittsburgh, Pittsburgh, PA, United States
Ziwei Lin: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
Shen Qu: Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China

DOI: https://doi.org/10.3389/fendo.2022.989202
Journal volume & issue: Vol. 13

Abstract

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ObjectivesTo assess the benefit of a bariatric surgery in four artificial intelligence-identified metabolic (AIM) subtypes of obesity with respect to the improvement of glucometabolism and the remission of diabetes and hyperinsulinemia.MethodsThis multicenter retrospective study prospectively collected data from five hospitals in China from 2010 to 2021. At baseline 1008 patients who underwent a bariatric surgery were enrolled (median age 31 years; median BMI 38.1kg/m2; 57.40% women) and grouped into the four AIM subtypes. Baseline and follow-up data (506 and 359 patients at 3- and 12-month post-surgery) were collected for longitudinal effect analysis.ResultsOut of the four AIM subgroups, hypometabolic obesity (LMO) group was characterized by decompensated insulin secretion and high incidence of diabetes (99.2%) pre-surgery. After surgery, 62.1% of LMO patients with diabetes achieved remission, lower than the other three subgroups. Still, the bariatric surgery significantly reduced their blood glucose (median HbA1c decreased by 27.2%). The hypermetabolic obesity-hyperinsulinemia (HMO-I) group was characterized by severe insulin resistance and high incidence of hyperinsulinemia (87.8%) pre-surgery, which had been greatly alleviated post-surgery. For both metabolic healthy obesity (MHO) and hypermetabolic obesity-hyperuricemia (HMO-U) groups who showed a relatively healthy glucometabolism pre-surgery, rate of glucometabolic comorbidities improved moderately post-surgery.ConclusionIn terms of glucometabolism, the four AIM subtypes of patients benefited differently from a bariatric surgery, which significantly relieved hyperglycemia and hyperinsulinemia for the LMO and HMO-I patients, respectively. The AIM-based subtypes may help better inform clinical decisions on bariatric surgery and patient counseling pertaining to post-surgery outcomes.

Published in Frontiers in Endocrinology

ISSN: 1664-2392 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.frontiersin.org/journals/endocrinology

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