Sera of Obese Type 2 Diabetic Patients Undergoing Metabolic Surgery Instead of Conventional Treatment Exert Beneficial Effects on Beta Cell Survival and Function: Results of a Randomized Clinical Study

Obes Surg. 2019 May;29(5):1485-1497. doi: 10.1007/s11695-019-03710-0.

Abstract

Background: Pancreatic beta cells are highly sensitive to oxidative and endoplasmic reticulum (ER) stress, commonly occurring in type 2 diabetes (T2D) and obesity.

Objective: We aimed at investigating cellular responses of human beta cells exposed to sera from obese T2D patients treated differently, namely by conventional therapy or laparoscopic sleeve gastrectomy (LSG).

Methods: Serum samples from obese T2D men randomized to conventional treatment or LSG were taken at baseline and 6 months later. After exposing 1.1B4 cells to study patients' sera, the following were assessed: cellular viability and proliferation (by MTT and xCELLigence assays), reactive oxygen species (ROS) production (with DCFH-DA), and expression of ER stress markers, oxidative- or autophagy-related proteins and insulin (by real-time PCR and Western blot).

Results: At 6-month follow-up, patients undergoing LSG achieved an adequate glycemic control, whereas conventionally treated patients did not. As compared to 1.1B4 cells incubated with baseline sera (control), cells exposed to sera from LSG-treated participants exhibited (i) increased viability and proliferation (p < 0.05); (ii) diminished levels of ROS and p53 (p < 0.05); (iii) enhanced protein expression of autophagy-related SIRT1 and p62/SQSTM1 (p < 0.05); (iv) significantly decreased transcript levels of ER stress markers (p < 0.05); and (v) augmented insulin expression (p < 0.05). Conversely, the 6-month conventional therapy appeared not to impact on circulating redox status. Moreover, 1.1B4 cells exposed to sera from conventionally treated patients experienced mild ER stress.

Conclusion: Circulating factors in patients with improved diabetes after metabolic surgery exerted favorable effects on beta cell function and survival.

Keywords: ER stress; Human 1.1B4 beta cells; Laparoscopic sleeve gastrectomy; Obesity; Oxidative stress; Type 2 diabetes.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bariatric Surgery / methods*
  • Blood Glucose / metabolism
  • Cell Proliferation / physiology
  • Cell Survival / physiology
  • Cells, Cultured
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / pathology
  • Diabetes Mellitus, Type 2 / surgery*
  • Endoplasmic Reticulum Stress / physiology
  • Follow-Up Studies
  • Gastrectomy / methods
  • Humans
  • Insulin / blood
  • Insulin-Secreting Cells / pathology*
  • Insulin-Secreting Cells / physiology
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / pathology
  • Obesity / surgery*
  • Obesity, Morbid / blood
  • Obesity, Morbid / pathology
  • Obesity, Morbid / surgery
  • Oxidation-Reduction
  • Postoperative Period
  • Reactive Oxygen Species / metabolism

Substances

  • Blood Glucose
  • Insulin
  • Reactive Oxygen Species