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Publication
Circulating Apolipoprotein A-IV presurgical levels are associated with
improvement in insulin sensitivity after Roux-en-Y gastric bypass surgery.
Authors Rao R, Roche A, Febres G, Bessler M, Tso P, Korner J
Submitted By Submitted Externally on 4/24/2018
Status Published
Journal Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Year 2017
Date Published 3/1/2017
Volume : Pages 13 : 468 - 473
PubMed Reference 27986588
Abstract Apolipoprotein A-IV (ApoA-IV) has been shown to be involved in obesity and
diabetes pathogenesis in animal studies, but its role in humans is uncertain.,
The objective of this study was to determine the relation of ApoA-IV with
changes in glucose metabolism and weight after bariatric surgery., University
Hospital., The patients (n = 49) included lean controls (n = 8) and patients
before and after a mean of 7 months after laparoscopic adjustable gastric
banding (LAGB, n = 12), laparoscopic Roux-en-Y gastric bypass (RYGB, n = 22), or
laparoscopic sleeve gastrectomy (SG, n = 11). ApoA-IV and other hormone assays
were performed in the fasting and the postprandial state. Pearson's correlation
analyses controlled for baseline BMI and percent excess weight loss (EWL) were
used to determine relationships between ApoA-IV levels and insulin resistance
(HOMA-IR)., With all bariatric procedures combined, the change in ApoA-IV [533
versus 518 microg/L, P = .813] or ApoA-IV area under the curve (AUC - 1072
versus 1042, P = .939) was not significant. None of the surgeries individually
affected levels of fasting or ApoA-IV AUC. Bariatric surgery resulted in a
decrease in HOMA-IR (5.3 versus 2.0, P<.001). In the RYGB group, higher baseline
ApoA-IV levels correlated with decrease in HOMA-IR [r = -.6, P = .008]. This
relationship was independent of EWL and was not observed in the LAGB or SG
group. There was no association of ApoA-IV levels with EWL, insulin secretion,
Peptide-YY, or leptin levels., Preoperative ApoA-IV levels, rather than changes
in levels, positively correlate with improvements in insulin sensitivity
independent of weight loss after RYGB.




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