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Lin Z, Zhang D, Zhang X, Guo W, Wang W, Zhang Y, Liu Z, Bi Y, Wu M, Lin Z, Lu X. Extracellular status of thrombospondin-2 in type 2 diabetes mellitus and utility as a biomarker in the determination of early diabetic kidney disease. BMC Nephrol 2023; 24:154. [PMID: 37259071 DOI: 10.1186/s12882-023-03216-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE Thrombospondin-2 (TSP-2) is a multifunctional matricellular glycoprotein correlated with glucose homeostasis, insulin sensitivity, and estimated glomerular filtration rate. Investigation of the association of TSP-2 with type 2 diabetes mellitus (T2DM) and the potential diagnostic value of serum TSP-2 for detecting early diabetic kidney disease (DKD) is needed. RESEARCH DESIGN AND METHODS An enzyme-linked immunosorbent assay was used for detection serum TSP-2 levels in 494 Chinese T2DM subjects. The protein expression of TSP-2 in the kidney and other tissues were tested by western blotting. RESULTS Serum TSP-2 levels in T2DM subjects were significantly higher than in healthy individuals. Serum TSP-2 correlated positively with triglycerides, serum uric acid, creatinine, platelets, and urinary albumin-to-creatinine ratio (UACR), but negatively with estimated glomerular filtration rate, after adjusting for age, sex, and T2DM duration. Logistic regression analysis demonstrated an independent association between serum TSP-2 and early DKD. Furthermore, the high UACR identified at risk of early DKD increased significantly from 0.78 (95%CI 0.73-0.83) to 0.82 (95%CI 0.77-0.86, p < 0.001) when added to a clinical model consisting of TSP-2 and age. In db/db mice, serum TSP-2 levels were elevated. TSP-2 expression was markedly increased in the kidney tissue compared with that in db/m and m/m mice. Furthermore, serum TSP-2 expression correlated well with UACR in mice. CONCLUSIONS TSP-2 is a novel glycoprotein associated with early DKD in patients with T2DM. The paradoxical increase of serum TSP-2 in T2DM individuals may be due to a compensatory response to chronic inflammatory and renal vascular endothelial growth, warranting further investigation.
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Affiliation(s)
- Zhenzhen Lin
- The 3rd Affiliated Hospital of Wenzhou Medical University (Ruian People's Hospital), Wenzhou, 325200, China
| | - Didong Zhang
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Xinxin Zhang
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Wanxie Guo
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Wenjun Wang
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Yingchao Zhang
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Zhen Liu
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Yanxue Bi
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Maolan Wu
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China
| | - Zhuofeng Lin
- School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China.
- The 1st Affiliated Hospital of Wenzhou Medical Unversity, South Baixiang Town, Wenzhou, 325000, China.
- Laboratory Animal Center of Wenzhou Medical University, Wenzhou, China.
| | - Xuemian Lu
- The 3rd Affiliated Hospital of Wenzhou Medical University (Ruian People's Hospital), Wenzhou, 325200, China.
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Wu X, Cheung CKY, Ye D, Chakrabarti S, Mahajan H, Yan S, Song E, Yang W, Lee CH, Lam KSL, Wang C, Xu A. Serum Thrombospondin-2 Levels Are Closely Associated With the Severity of Metabolic Syndrome and Metabolic Associated Fatty Liver Disease. J Clin Endocrinol Metab 2022; 107:e3230-e3240. [PMID: 35532410 DOI: 10.1210/clinem/dgac292] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Metabolic associated fatty liver disease (MAFLD) is the hepatic manifestation of obesity-related metabolic syndrome (MetS). Noninvasive biomarkers for monitoring the progression and severity of these metabolic comorbidities are needed. OBJECTIVES To investigate the associations of serum thrombospondin-2 (TSP2) with MetS and MAFLD severity, and the potential diagnostic value of serum TSP2 for identifying at-risk metabolic associated steatohepatitis (MASH). METHODS Blood samples, clinical data, and liver biopsies were collected from consecutively recruited 252 individuals with morbid obesity receiving bariatric surgery. Histopathology samples of liver biopsies were examined in a blinded fashion by 3 independent pathologists. Serum TSP2 levels were measured by enzyme-linked immunosorbent assay. RESULTS Serum TSP2 levels were significantly elevated in MetS (1.58 [1.07-2.20] ng/mL) compared with non-MetS (1.28 [0.84-1.73] ng/mL; P = .006) in obese patients and positively correlated with increasing number of the MetS components, fasting glucose, glycated hemoglobin, fasting insulin, C-peptide, and homeostatic model assessment of insulin resistance after adjustment of conventional confounders. Serum TSP2 levels differentiated MASH (1.74 [1.32-3.09] ng/mL) from the other non-MASH less severe groups: normal liver (1.41 [1.04-1.63] ng/mL), simple steatosis (1.45 [0.89-1.92] ng/mL), and borderline MASH (1.30 [0.99-2.17] ng/mL) (P < .05). Elevated serum TSP2 was positively associated with the severity of hepatic steatosis, inflammation, fibrosis, and abnormal liver function independent of age, sex and adiposity. Furthermore, high serum TSP2 identified at-risk MASH with area under the operating curve of 0.84 (95% CI 0.70-0.98). CONCLUSION Serum TSP2 is closely associated with severity and progression of MetS and MAFLD, and is a promising noninvasive biomarker for differentiating MASH from benign steatosis and identifying at-risk MASH patients among individuals with obesity.
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Affiliation(s)
- Xuerui Wu
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, China
| | - Cynthia Kwan Yui Cheung
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Dewei Ye
- Key Laboratory of Glucolipid Metabolic Diseases of the Ministry of Education, Guangdong Pharmaceutical University, Guangzhou, China
| | - Subrata Chakrabarti
- Department of Pathology and Laboratory Medicine, Western University, Canada
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre, Canada
| | - Hema Mahajan
- Insititue of Clinical Pathology and Medical Research, Pathology West, NSW Health Pathology, Sydney, NSW 2145, Australia
- University of Sydney, New South Wales, Australia
- Western Sydney University, New South Wales, Australia
| | - Sen Yan
- Dr. Everett Chalmers Hospital, New Brunswick, Canada
| | - Erfei Song
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Chi Ho Lee
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Karen Siu Ling Lam
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Aimin Xu
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, China
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
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Gastrointestinal stromal tumor of the excluded stomach after Roux-en-Y gastric bypass: A case report and literature review. Int J Surg Case Rep 2020; 74:196-200. [PMID: 32890896 PMCID: PMC7481502 DOI: 10.1016/j.ijscr.2020.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022] Open
Abstract
This is the second reported case of GIST post-RYGB. GISTs generally present good prognosis after surgical resection. The case reported after RYGB did not present the patient follow-up. The case reported after gastric banding presented recurrence 3 years after resection.
Background Gastric cancer is an extremely rare condition to occur after bariatric surgery, and most of the reported cases are adenocarcinomas. Regarding gastrointestinal stromal tumors (GISTs), there are only two reported cases occurring after bariatric surgery (one after gastric banding and the other following Roux-en-Y gastric bypass (RYGB)). Case presentation A 48-year-old woman with previous history of obesity and type 2 diabetes, treated with a Roux-en-Y gastric bypass 2 years earlier, was referred to our center due to complains of diffuse abdominal pain and distension associated with asthenia. Magnetic resonance imaging showed a cystic-solid mass located in the right hypochondrium, measuring 19.5 × 13.5 × 16 cm, suggesting the diagnosis of a retroperitoneal tumor. Based on these findings, a laparotomy, evidencing that the larger cystic-solid tumor was originating from the excluded stomach post-RYGB. The gastrectomy of the excluded stomach was performed aside with a conventional cholecystectomy. Histopathology and immunohistochemistry confirmed to be a gastric GIST with epithelioid cells. Currently, 12 months after surgery, the patient presents no signs of recurrence. Conclusion This is the second case of gastric GIST occurring after RYGB to be reported in the literature.
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Noronha CG, Silva RO, Siqueira LT, Santa-Cruz F, Dompieri LT, Luz TPSR, Albuquerque MARC, Ferraz ÁAB. Metabonomic model for the assessment of type 2 diabetes remission after bariatric/metabolic surgery. ACTA ACUST UNITED AC 2020; 47:e20202394. [PMID: 32555961 DOI: 10.1590/0100-6991e-20202394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 11/20/2019] [Indexed: 02/08/2023]
Abstract
OBJETIVO To evaluate the differences in the metabonomic profile of patients who achieved remisison of Type 2 diabetes mellitus (T2DM) after bariatric surgery in relation to those who presented maintenance or recurrence of this condition after surgery. METHODS Thirthy-three patients with obesity and T2D were submitted to bariatric/metabolic surgery, among which, 22 experienced complete remission of T2D, and 11 did not experience remission in the postoperative period. Blood samples were taken in order to assess the serum profiles through a 1H NMR-based metabonomic study. RESULTS The metabonomic model for the assessment of T2D recurrence presented an accuracy of 93.9%, sensibility of 81.8%, specificity of 100%, positive predictive value of 100% and a negative predictive value of 91.7%. CONCLUSION bariatric surgery provide specific effects on the distribution of metabolites in those patients who achieved remission of T2DM, and this new distribution can be assessed through a metabonomic model.
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Affiliation(s)
- Clarissa G Noronha
- Universidade Federal de Pernambuco (UFPE), Pós-graduação em Cirurgia - Recife - PE - Brasil
| | - Ricardo O Silva
- Universidade Federal de Pernambuco (UFPE), Departamento de Química Fundamental - Recife - PE - Brasil
| | - Luciana T Siqueira
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia - Recife - PE - Brasil
| | - Fernando Santa-Cruz
- Universidade Federal de Pernambuco (UFPE), Curso de Medicina - Recife - PE - Brasil
| | - Luca T Dompieri
- Universidade Federal de Pernambuco (UFPE), Curso de Medicina - Recife - PE - Brasil
| | - Tatiane Priscila S R Luz
- Universidade Federal de Pernambuco (UFPE), Departamento de Química Fundamental - Recife - PE - Brasil
| | | | - Álvaro A B Ferraz
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia - Recife - PE - Brasil
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Lima RLS, Oliveira EJSGD, Pereira EC, Costa LDS, Dourado TS, Valadão JA, Lima RC, Campelo GP, Brito RMD, Oliveira CMBD, Moura ECR, Leal PDC. Comparative analysis between patients undergoing Gastric Bypass and Sleeve Gastroplasty in a private hospital in Sao Luis-MA. Acta Cir Bras 2020; 35:e202000307. [PMID: 32692798 PMCID: PMC7251972 DOI: 10.1590/s0102-865020200030000007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 02/01/2020] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To compare the satisfaction levels about the surgery and anesthesia management, and to analyze the postoperative outcomes of patients undergoing Gastric Bypass and Sleeve Gastroplasty surgeries in a private hospital in Sao Luís-MA. METHODS The sample consisted of patients undergoing Bypass and Sleeve bariatric surgeries from August 2018 to August 2019, who were in the range of 18 and 70 years old and had not used drugs or presented cardiac arrhythmias, dilated cardiomyopathy, and conduction disorder heart. Data were collected from the evaluation forms and recorded in a form with closed questions. RESULTS Most patients were female (Bypass - 56% and Sleeve - 67.4%) and aged between 30 and 39 years old (Bypass - 32% and Sleeve - 55.8%). Information (Bypass - 92% and Sleeve - 86.1%) was the highest satisfaction index found. Sleepiness in the immediate postoperative period (Bypass - 92% and Sleeve - 93%) was the main side effect. There were no postoperative complications in patients between the two types of surgery. CONCLUSIONS Patients submitted to Bypass and Sleeve were completely satisfied with the perioperative management. There was no statistically significant difference when comparing adverse effects between the techniques.
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Castanha CR, Tcbc-Pe ÁABF, Castanha AR, Belo GDQMB, Lacerda RMR, Vilar L. Evaluation of quality of life, weight loss and comorbidities of patients undergoing bariatric surgery. ACTA ACUST UNITED AC 2018; 45:e1864. [PMID: 30020323 DOI: 10.1590/0100-6991e-20181864] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 05/10/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE to assess the efficacy of weight loss, the evolution of comorbidities, the quality of life and the BAROS protocol (Bariatric Analysis and Reporting Outcome System) in the postoperative period of patients undergoing bariatric surgery. METHODS we conducted a cross-sectional, quantitative study with 95% true strength (P=0.05), with 103 patients submitted to SLEEVE Vertical Gastrectomy (40) and Roux-en-Y Gastric Bypass (63), from four months after surgery. We carried out the research at the Ambulatory of General Surgery of the Clinics Hospital of the Federal University of Pernambuco, using the BAROS protocol. RESULTS the majority of the patients were female (89.3%). The mean age was 44.23 years. The mean percentage loss of excess weight was 69.35%. The mean postoperative follow-up time was 41.87 months (±37.35). The comorbidities with the highest percentage of resolution were sleep apnea (90.2%), diabetes (80.7%) and hypertension (70.8%). The most frequent complications were hair loss (79.6%), nutritional deficiency (37.9%) and anemia (35%). The BAROS protocol demonstrated that patients positively evaluated quality of life in 93.2% of the cases. The Moorehead-Ardelt questionnaire showed that quality of life "improved" or "improved greatly" for 94.1% of patients. CONCLUSION bariatric surgery has been shown to be an effective procedure in the treatment of morbid obesity and in the control of comorbidities. Quality of life analysis was evaluated positively through the BAROS protocol.
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Affiliation(s)
| | | | | | | | | | - Lúcio Vilar
- Universidade Federal de Pernambuco, Departamento de Cirurgia e Medicina Clínica, Recife, PE, Brasil
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