PMID- 34378729
OWN - NLM
STAT- MEDLINE
DCOM- 20210927
LR  - 20220629
IS  - 1980-5322 (Electronic)
IS  - 1807-5932 (Print)
IS  - 1807-5932 (Linking)
VI  - 76
DP  - 2021
TI  - C-peptide level as predictor of type 2 diabetes remission and body composition 
      changes in non-diabetic and diabetic patients after Roux-en-Y gastric bypass.
PG  - e2906
LID - 10.6061/clinics/2021/e2906 [doi]
LID - e2906
AB  - OBJECTIVES: Several predictors of type 2 diabetes mellitus (T2DM) remission after 
      metabolic surgery have been proposed and used to develop predictive scores. These 
      scores may not be reproducible in diverse geographic regions with different 
      baseline characteristics. This study aimed to identify predictive factors 
      associated with T2DM remission after Roux-en-Y gastric bypass (RYGB) in patients 
      with severe obesity. We hypothesized that the body composition alterations 
      induced by bariatric surgery could also contribute to diabetes remission. 
      METHODS: We retrospectively evaluated 100 patients with severe obesity and T2DM 
      who underwent RYGB between 2014 and 2016 for preoperative factors (age, diabetes 
      duration, insulin use, HbA1c, C-peptide plasma level, and basal insulinemia) to 
      identify predictors of T2DM remission (glycemia<126 mg/dL and/or HbA1c<6.5%) at 3 
      years postoperatively. The potential preoperative predictors were prospectively 
      applied to 20 other patients with obesity and T2DM who underwent RYGB for 
      validation. In addition, 81 patients with severe obesity (33 with T2DM) underwent 
      body composition evaluations by bioelectrical impedance analysis (InBody 770(R)) 1 
      year after RYGB for comparison of body composition changes between patients with 
      and those without T2DM. RESULTS: The retrospective analysis identified only a 
      C-peptide level >3 ng/dL as a positive predictor of 3-year postoperative diabetes 
      remission, which was validated in the prospective phase. There was a significant 
      difference in the postoperative body composition changes between non-diabetic and 
      diabetic patients only in trunk mass. CONCLUSION: Preoperative C-peptide levels 
      can be useful for predicting T2DM remission after RYGB. Trunk mass is the most 
      important difference in postoperative body composition changes between 
      non-diabetic and diabetic patients.
FAU - de Cleva, Roberto
AU  - de Cleva R
AUID- ORCID: 0000-0001-8673-9014
AD  - Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de 
      Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
FAU - Kawamoto, Flavio
AU  - Kawamoto F
AUID- ORCID: 0000-0002-2391-2796
AD  - Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de 
      Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
FAU - Borges, Georgia
AU  - Borges G
AUID- ORCID: 0000-0002-2379-8604
AD  - Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de 
      Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
FAU - Caproni, Priscila
AU  - Caproni P
AUID- ORCID: 0000-0002-6427-193X
AD  - Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de 
      Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
FAU - Cassenote, Alex Jones Flores
AU  - Cassenote AJF
AUID- ORCID: 0000-0002-5098-1922
AD  - Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de 
      Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
FAU - Santo, Marco Aurelio
AU  - Santo MA
AUID- ORCID: 0000-0002-7813-6210
AD  - Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de 
      Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210804
PL  - United States
TA  - Clinics (Sao Paulo)
JT  - Clinics (Sao Paulo, Brazil)
JID - 101244734
RN  - 0 (C-Peptide)
SB  - IM
MH  - Body Composition
MH  - Body Mass Index
MH  - C-Peptide
MH  - Child, Preschool
MH  - *Diabetes Mellitus, Type 2
MH  - *Gastric Bypass
MH  - Humans
MH  - *Obesity, Morbid/surgery
MH  - Prospective Studies
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC8311643
COIS- No potential conflict of interest was reported.
EDAT- 2021/08/12 06:00
MHDA- 2021/09/28 06:00
PMCR- 2021/07/26
CRDT- 2021/08/11 09:05
PHST- 2021/04/17 00:00 [received]
PHST- 2021/06/11 00:00 [accepted]
PHST- 2021/08/11 09:05 [entrez]
PHST- 2021/08/12 06:00 [pubmed]
PHST- 2021/09/28 06:00 [medline]
PHST- 2021/07/26 00:00 [pmc-release]
AID - S1807-5932(22)00185-5 [pii]
AID - cln_76p1 [pii]
AID - 10.6061/clinics/2021/e2906 [doi]
PST - epublish
SO  - Clinics (Sao Paulo). 2021 Aug 4;76:e2906. doi: 10.6061/clinics/2021/e2906. 
      eCollection 2021.