PMID- 23292561
OWN - NLM
STAT- MEDLINE
DCOM- 20140116
LR  - 20211021
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 27
IP  - 6
DP  - 2013 Jun
TI  - Weight loss independently predicts urinary albumin excretion normalization in 
      morbidly obese type 2 diabetic patients undergoing bariatric surgery.
PG  - 2046-51
LID - 10.1007/s00464-012-2708-3 [doi]
AB  - BACKGROUND: Despite obesity being closely associated with two common risk factors 
      for albuminuria, namely type 2 diabetes mellitus (T2DM) and hypertension, 
      information on the impact of weight loss on albumin excretion rate in morbidly 
      obese (MO) subjects is scarce. OBJECTIVE: To evaluate the independent 
      contribution of weight loss following bariatric surgery (BS) to the improvement 
      of the albumin-to-creatinine ratio (ACR) in MO subjects with T2DM. SUBJECTS AND 
      METHODS: Observational prospective study, including consecutive (n = 255) 
      patients undergoing Roux-en-Y gastric bypass (GBP) or sleeve gastrectomy (SG) of 
      whom 37.6 % (n = 96) presented with T2DM. Stepwise logistic regression analysis 
      was used to assess the contribution of T2DM-related, hypertension-related, and 
      weight loss-related variables, and type of surgery to normalization of ACR (<30 
      mg/g) at 12 and 24 months follow-up. RESULTS: In T2DM subjects, baseline ACR was 
      85.7 +/- 171 mg/g with ACR >/= 30 mg/g being present in 45.7 % of the cohort. At 12 
      months, the ACR significantly decreased in T2DM subjects (42.2 +/- 142.8 mg/g; p < 
      0.005) with no further reduction at 24 months after surgery (44.4 +/- 227.7; p = 
      0.862). Among T2DM subjects with ACR >/= 30 mg/g at baseline, the ACR became <30 
      mg/g in 58.5 % and 76.9 % at 12 and 24 months, respectively (p < 0.001 relative 
      to baseline). Body mass index (BMI) change from baseline was the only independent 
      predictor of ACR normalization at 12 months [Exp(B) 1.373, 95 % confidence 
      interval 1.075-1.703; p < 0.05]. None of the evaluated variables appeared as an 
      independent predictor of ACR normalization at 24 months. CONCLUSIONS: Our data 
      suggest that, in MO subjects with T2DM, interventions aiming at slowing the 
      progression of nephropathy should not only focus on optimization of glucose and 
      blood pressure control but also include effective weight loss strategies.
FAU - Amor, Antonio
AU  - Amor A
AD  - Obesity Unit, Endocrinology and Diabetes Department, Hospital Clinic 
      Universitari, Villarroel 170, 08036, Barcelona, Spain.
FAU - Jimenez, Amanda
AU  - Jimenez A
FAU - Moize, Violeta
AU  - Moize V
FAU - Ibarzabal, Ainitze
AU  - Ibarzabal A
FAU - Flores, Lilliam
AU  - Flores L
FAU - Lacy, Antonio M
AU  - Lacy AM
FAU - Vidal, Josep
AU  - Vidal J
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130105
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Albuminuria/*urine
MH  - *Bariatric Surgery
MH  - Creatinine/urine
MH  - Diabetes Mellitus, Type 2/*complications/urine
MH  - Diabetic Nephropathies/urine
MH  - Female
MH  - Gastrectomy
MH  - Gastric Bypass
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*surgery/urine
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Weight Loss/*physiology
EDAT- 2013/01/08 06:00
MHDA- 2014/01/17 06:00
CRDT- 2013/01/08 06:00
PHST- 2012/06/28 00:00 [received]
PHST- 2012/11/06 00:00 [accepted]
PHST- 2013/01/08 06:00 [entrez]
PHST- 2013/01/08 06:00 [pubmed]
PHST- 2014/01/17 06:00 [medline]
AID - 10.1007/s00464-012-2708-3 [doi]
PST - ppublish
SO  - Surg Endosc. 2013 Jun;27(6):2046-51. doi: 10.1007/s00464-012-2708-3. Epub 2013 
      Jan 5.