Preoperative osteopontin levels predict diabetes remission after bariatric surgery

Takeaway

• High preoperative serum osteopontin levels can predict the 3-year post-surgery remission of type 2 diabetes mellitus (T2DM).
• Osteopontin levels correlated positively with lower postoperative BMI and recovery of insulin sensitivity.

Why this matters

• Evidence regarding biological modifications induced by metabolic surgery is limited.

Study design

• Retrospective study evaluated 41 patients with T2DM who underwent bariatric surgery.
• Computer models for homoeostasis model assessment (HOMA2) were used to calculate indices of insulin resistance, beta-cell function and insulin sensitivity.
• Complete T2DM remission defined as normal fasting glycaemia (<5.6 mmol/L) lasting ≥1 year in absence of any antidiabetic medication.
• Funding: European Commission.

Key results

• At baseline, patients experiencing T2DM remission vs nonremitters had:
  • higher prevalence of morbid obesity (57.1% vs 14.8%; P=.010),
  • increased BMI (39.0 vs 30.7 kg/m²; P=.002) and
  • higher serum osteopontin levels (50.97 vs 25.98 ng/mL; P=.009).
• T2DM remission was predicted by preoperative osteopontin values, independent of diabetes duration, changes in weight, and baseline BMI and fibrinogen (OR, 1.05; P=.035).
• Preoperative osteopontin levels significantly correlated with reductions in body weight (r, 0.445; P=.006) and BMI (r, 0.421; P=.011) over time.
• At 3 years, only insulin sensitivity remained independently associated with preoperative osteopontin levels (B, 0.227; P=.010).
• Bariatric surgery was associated with improved lipid and glucose profiles in patients with/without T2DM remission, although beta-cell function (P=.043) improved only in the T2DM remission group at 3-year follow-up.

Limitations

• Small study population.
• Single-centre design.