Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study
Purpose There are limited data on the impact of bariatric surgery on microvascular complications of type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed microvascular complications (especially neuropathy) in obese patients with T2D before and 12 months after bariatric surgery. Materi...
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| Veröffentlicht in: | Obesity surgery 2021-02, Vol.31 (2), p.554-563 |
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| creator | Adam, Safwaan Azmi, Shazli Ho, Jan H. Liu, Yifen Ferdousi, Maryam Siahmansur, Tarza Kalteniece, Alise Marshall, Andrew Dhage, Shaishav S. Iqbal, Zohaib D’Souza, Yvonne Natha, Salim Kalra, Philip A. Donn, Rachelle Ammori, Basil J. Syed, Akheel A. Durrington, Paul N. Malik, Rayaz A. Soran, Handrean |
| description | Purpose
There are limited data on the impact of bariatric surgery on microvascular complications of type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed microvascular complications (especially neuropathy) in obese patients with T2D before and 12 months after bariatric surgery.
Materials and Methods
This was a prospective observational cohort study. Measurements of neuropathy symptom profile (NSP), neuropathy disability score (NDS), vibration (VPT), cold (CPT) and warm (WPT) perception thresholds, nerve conduction studies (NCS) and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), branch density (CNBD) and fibre length (CNFL); urinary albumin/creatinine ratio (uACR), estimated glomerular filtration rate (eGFRcyst-creat) and retinal grading were taken.
Results
Twenty-six (62% female; median age 52 years) obese patients with T2D were recruited. Body mass index (BMI) (47.2 to 34.5 kg/m
2
;
p
|
| doi_str_mv | 10.1007/s11695-020-05052-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_journals_2484152045</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2454655254</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-448b5c7d5a2908ccbb1ae8f97096d7625410423dcc1ec3035f9029b2c3c035373</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS0EIkPgB1ggS2zYNJRfbZsFUhhekSJACqwtt9s942i63bHdI83fY5gkPBasrFKduq5bF6GnBF4SAPkqE9Jq0QCFBgQI2qh7aEUkqAY4VffRCnQLjdKUnaBHOV8BUNJS-hCdMEaAa6VXaHM-zinu_einknGY8LtgO1-Cw5_9kuJsy_aA7dTXct7e1mdD8Qm_tSnYkip6uaSNT4fX2OKvKebZuxL2Hq_jNqaCL8vSHx6jB4PdZf_k5j1F3z-8_7b-1Fx8-Xi-PrtoHJe8NJyrTjjZC0s1KOe6jlivBi2rlV62VPC6OGW9c8Q7BkwMGqjuqGOuFkyyU_TmqDsv3eh7V20luzNzCqNNBxNtMH93prA1m7g3UnGpWloFXtwIpHi9-FzMGLLzu52dfFyyoVzwVoi6SUWf_4NexSVN1V6lFCeCAheVokfK1dPk5Ie7ZQiYnzmaY46m5mh-5WhUHXr2p427kdvgKsCOQK6tqV7_99__kf0BSBeplg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2484152045</pqid></control><display><type>article</type><title>Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Adam, Safwaan ; Azmi, Shazli ; Ho, Jan H. ; Liu, Yifen ; Ferdousi, Maryam ; Siahmansur, Tarza ; Kalteniece, Alise ; Marshall, Andrew ; Dhage, Shaishav S. ; Iqbal, Zohaib ; D’Souza, Yvonne ; Natha, Salim ; Kalra, Philip A. ; Donn, Rachelle ; Ammori, Basil J. ; Syed, Akheel A. ; Durrington, Paul N. ; Malik, Rayaz A. ; Soran, Handrean</creator><creatorcontrib>Adam, Safwaan ; Azmi, Shazli ; Ho, Jan H. ; Liu, Yifen ; Ferdousi, Maryam ; Siahmansur, Tarza ; Kalteniece, Alise ; Marshall, Andrew ; Dhage, Shaishav S. ; Iqbal, Zohaib ; D’Souza, Yvonne ; Natha, Salim ; Kalra, Philip A. ; Donn, Rachelle ; Ammori, Basil J. ; Syed, Akheel A. ; Durrington, Paul N. ; Malik, Rayaz A. ; Soran, Handrean</creatorcontrib><description>Purpose
There are limited data on the impact of bariatric surgery on microvascular complications of type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed microvascular complications (especially neuropathy) in obese patients with T2D before and 12 months after bariatric surgery.
Materials and Methods
This was a prospective observational cohort study. Measurements of neuropathy symptom profile (NSP), neuropathy disability score (NDS), vibration (VPT), cold (CPT) and warm (WPT) perception thresholds, nerve conduction studies (NCS) and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), branch density (CNBD) and fibre length (CNFL); urinary albumin/creatinine ratio (uACR), estimated glomerular filtration rate (eGFRcyst-creat) and retinal grading were taken.
Results
Twenty-six (62% female; median age 52 years) obese patients with T2D were recruited. Body mass index (BMI) (47.2 to 34.5 kg/m
2
;
p
< 0.001) decreased post-operatively. There were improvements in CNFD (27.1 to 29.2/mm
2
;
p
= 0.005), CNBD (63.4 to 77.8/mm
2
;
p
= 0.008), CNFL (20.0 to 20.2/mm
2
;
p
= 0.001), NSP (3 to 0/38;
p
< 0.001) and eGFRcyst-creat (128 to 120 ml/min;
p
= 0.015) post-bariatric surgery. Changes in (Δ) triglycerides were independently associated with ΔCNFL (
β
= − 0.53;
p
= 0.024) and Δsystolic blood pressure (β = 0.62;
p
= 0.017), and %excess BMI loss (
β
= − 0.004;
p
= 0.018) were associated with ΔeGFRcyst-creat. There was no significant change in NDS, VPT, CPT, WPT, NCS, uACR or retinopathy status. Glomerular hyperfiltration resolved in 42% of the 12 patients with this condition pre-operatively.
Conclusion
Bariatric surgery results in improvements in small nerve fibres and glomerular hyperfiltration in obese people with T2D, which were associated with weight loss, triglycerides and systolic blood pressure, but with no change in retinopathy or uACR at 12 months.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-020-05052-8</identifier><identifier>PMID: 33104989</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bariatric Surgery ; Blood pressure ; Cohort analysis ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - surgery ; Diabetic Neuropathies - etiology ; Diabetic neuropathy ; Female ; Gastrointestinal surgery ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity, Morbid - surgery ; Original Contributions ; Prospective Studies ; Surgery ; Triglycerides</subject><ispartof>Obesity surgery, 2021-02, Vol.31 (2), p.554-563</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-448b5c7d5a2908ccbb1ae8f97096d7625410423dcc1ec3035f9029b2c3c035373</citedby><cites>FETCH-LOGICAL-c474t-448b5c7d5a2908ccbb1ae8f97096d7625410423dcc1ec3035f9029b2c3c035373</cites><orcidid>0000-0001-8004-1897</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-020-05052-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-020-05052-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33104989$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adam, Safwaan</creatorcontrib><creatorcontrib>Azmi, Shazli</creatorcontrib><creatorcontrib>Ho, Jan H.</creatorcontrib><creatorcontrib>Liu, Yifen</creatorcontrib><creatorcontrib>Ferdousi, Maryam</creatorcontrib><creatorcontrib>Siahmansur, Tarza</creatorcontrib><creatorcontrib>Kalteniece, Alise</creatorcontrib><creatorcontrib>Marshall, Andrew</creatorcontrib><creatorcontrib>Dhage, Shaishav S.</creatorcontrib><creatorcontrib>Iqbal, Zohaib</creatorcontrib><creatorcontrib>D’Souza, Yvonne</creatorcontrib><creatorcontrib>Natha, Salim</creatorcontrib><creatorcontrib>Kalra, Philip A.</creatorcontrib><creatorcontrib>Donn, Rachelle</creatorcontrib><creatorcontrib>Ammori, Basil J.</creatorcontrib><creatorcontrib>Syed, Akheel A.</creatorcontrib><creatorcontrib>Durrington, Paul N.</creatorcontrib><creatorcontrib>Malik, Rayaz A.</creatorcontrib><creatorcontrib>Soran, Handrean</creatorcontrib><title>Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Purpose
There are limited data on the impact of bariatric surgery on microvascular complications of type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed microvascular complications (especially neuropathy) in obese patients with T2D before and 12 months after bariatric surgery.
Materials and Methods
This was a prospective observational cohort study. Measurements of neuropathy symptom profile (NSP), neuropathy disability score (NDS), vibration (VPT), cold (CPT) and warm (WPT) perception thresholds, nerve conduction studies (NCS) and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), branch density (CNBD) and fibre length (CNFL); urinary albumin/creatinine ratio (uACR), estimated glomerular filtration rate (eGFRcyst-creat) and retinal grading were taken.
Results
Twenty-six (62% female; median age 52 years) obese patients with T2D were recruited. Body mass index (BMI) (47.2 to 34.5 kg/m
2
;
p
< 0.001) decreased post-operatively. There were improvements in CNFD (27.1 to 29.2/mm
2
;
p
= 0.005), CNBD (63.4 to 77.8/mm
2
;
p
= 0.008), CNFL (20.0 to 20.2/mm
2
;
p
= 0.001), NSP (3 to 0/38;
p
< 0.001) and eGFRcyst-creat (128 to 120 ml/min;
p
= 0.015) post-bariatric surgery. Changes in (Δ) triglycerides were independently associated with ΔCNFL (
β
= − 0.53;
p
= 0.024) and Δsystolic blood pressure (β = 0.62;
p
= 0.017), and %excess BMI loss (
β
= − 0.004;
p
= 0.018) were associated with ΔeGFRcyst-creat. There was no significant change in NDS, VPT, CPT, WPT, NCS, uACR or retinopathy status. Glomerular hyperfiltration resolved in 42% of the 12 patients with this condition pre-operatively.
Conclusion
Bariatric surgery results in improvements in small nerve fibres and glomerular hyperfiltration in obese people with T2D, which were associated with weight loss, triglycerides and systolic blood pressure, but with no change in retinopathy or uACR at 12 months.</description><subject>Bariatric Surgery</subject><subject>Blood pressure</subject><subject>Cohort analysis</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - surgery</subject><subject>Diabetic Neuropathies - etiology</subject><subject>Diabetic neuropathy</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Prospective Studies</subject><subject>Surgery</subject><subject>Triglycerides</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctuFDEQRS0EIkPgB1ggS2zYNJRfbZsFUhhekSJACqwtt9s942i63bHdI83fY5gkPBasrFKduq5bF6GnBF4SAPkqE9Jq0QCFBgQI2qh7aEUkqAY4VffRCnQLjdKUnaBHOV8BUNJS-hCdMEaAa6VXaHM-zinu_einknGY8LtgO1-Cw5_9kuJsy_aA7dTXct7e1mdD8Qm_tSnYkip6uaSNT4fX2OKvKebZuxL2Hq_jNqaCL8vSHx6jB4PdZf_k5j1F3z-8_7b-1Fx8-Xi-PrtoHJe8NJyrTjjZC0s1KOe6jlivBi2rlV62VPC6OGW9c8Q7BkwMGqjuqGOuFkyyU_TmqDsv3eh7V20luzNzCqNNBxNtMH93prA1m7g3UnGpWloFXtwIpHi9-FzMGLLzu52dfFyyoVzwVoi6SUWf_4NexSVN1V6lFCeCAheVokfK1dPk5Ie7ZQiYnzmaY46m5mh-5WhUHXr2p427kdvgKsCOQK6tqV7_99__kf0BSBeplg</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Adam, Safwaan</creator><creator>Azmi, Shazli</creator><creator>Ho, Jan H.</creator><creator>Liu, Yifen</creator><creator>Ferdousi, Maryam</creator><creator>Siahmansur, Tarza</creator><creator>Kalteniece, Alise</creator><creator>Marshall, Andrew</creator><creator>Dhage, Shaishav S.</creator><creator>Iqbal, Zohaib</creator><creator>D’Souza, Yvonne</creator><creator>Natha, Salim</creator><creator>Kalra, Philip A.</creator><creator>Donn, Rachelle</creator><creator>Ammori, Basil J.</creator><creator>Syed, Akheel A.</creator><creator>Durrington, Paul N.</creator><creator>Malik, Rayaz A.</creator><creator>Soran, Handrean</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8004-1897</orcidid></search><sort><creationdate>20210201</creationdate><title>Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study</title><author>Adam, Safwaan ; Azmi, Shazli ; Ho, Jan H. ; Liu, Yifen ; Ferdousi, Maryam ; Siahmansur, Tarza ; Kalteniece, Alise ; Marshall, Andrew ; Dhage, Shaishav S. ; Iqbal, Zohaib ; D’Souza, Yvonne ; Natha, Salim ; Kalra, Philip A. ; Donn, Rachelle ; Ammori, Basil J. ; Syed, Akheel A. ; Durrington, Paul N. ; Malik, Rayaz A. ; Soran, Handrean</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-448b5c7d5a2908ccbb1ae8f97096d7625410423dcc1ec3035f9029b2c3c035373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bariatric Surgery</topic><topic>Blood pressure</topic><topic>Cohort analysis</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - surgery</topic><topic>Diabetic Neuropathies - etiology</topic><topic>Diabetic neuropathy</topic><topic>Female</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Prospective Studies</topic><topic>Surgery</topic><topic>Triglycerides</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adam, Safwaan</creatorcontrib><creatorcontrib>Azmi, Shazli</creatorcontrib><creatorcontrib>Ho, Jan H.</creatorcontrib><creatorcontrib>Liu, Yifen</creatorcontrib><creatorcontrib>Ferdousi, Maryam</creatorcontrib><creatorcontrib>Siahmansur, Tarza</creatorcontrib><creatorcontrib>Kalteniece, Alise</creatorcontrib><creatorcontrib>Marshall, Andrew</creatorcontrib><creatorcontrib>Dhage, Shaishav S.</creatorcontrib><creatorcontrib>Iqbal, Zohaib</creatorcontrib><creatorcontrib>D’Souza, Yvonne</creatorcontrib><creatorcontrib>Natha, Salim</creatorcontrib><creatorcontrib>Kalra, Philip A.</creatorcontrib><creatorcontrib>Donn, Rachelle</creatorcontrib><creatorcontrib>Ammori, Basil J.</creatorcontrib><creatorcontrib>Syed, Akheel A.</creatorcontrib><creatorcontrib>Durrington, Paul N.</creatorcontrib><creatorcontrib>Malik, Rayaz A.</creatorcontrib><creatorcontrib>Soran, Handrean</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adam, Safwaan</au><au>Azmi, Shazli</au><au>Ho, Jan H.</au><au>Liu, Yifen</au><au>Ferdousi, Maryam</au><au>Siahmansur, Tarza</au><au>Kalteniece, Alise</au><au>Marshall, Andrew</au><au>Dhage, Shaishav S.</au><au>Iqbal, Zohaib</au><au>D’Souza, Yvonne</au><au>Natha, Salim</au><au>Kalra, Philip A.</au><au>Donn, Rachelle</au><au>Ammori, Basil J.</au><au>Syed, Akheel A.</au><au>Durrington, Paul N.</au><au>Malik, Rayaz A.</au><au>Soran, Handrean</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>31</volume><issue>2</issue><spage>554</spage><epage>563</epage><pages>554-563</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Purpose
There are limited data on the impact of bariatric surgery on microvascular complications of type 2 diabetes (T2D), particularly diabetic neuropathy. We assessed microvascular complications (especially neuropathy) in obese patients with T2D before and 12 months after bariatric surgery.
Materials and Methods
This was a prospective observational cohort study. Measurements of neuropathy symptom profile (NSP), neuropathy disability score (NDS), vibration (VPT), cold (CPT) and warm (WPT) perception thresholds, nerve conduction studies (NCS) and corneal confocal microscopy (CCM) to quantify corneal nerve fibre density (CNFD), branch density (CNBD) and fibre length (CNFL); urinary albumin/creatinine ratio (uACR), estimated glomerular filtration rate (eGFRcyst-creat) and retinal grading were taken.
Results
Twenty-six (62% female; median age 52 years) obese patients with T2D were recruited. Body mass index (BMI) (47.2 to 34.5 kg/m
2
;
p
< 0.001) decreased post-operatively. There were improvements in CNFD (27.1 to 29.2/mm
2
;
p
= 0.005), CNBD (63.4 to 77.8/mm
2
;
p
= 0.008), CNFL (20.0 to 20.2/mm
2
;
p
= 0.001), NSP (3 to 0/38;
p
< 0.001) and eGFRcyst-creat (128 to 120 ml/min;
p
= 0.015) post-bariatric surgery. Changes in (Δ) triglycerides were independently associated with ΔCNFL (
β
= − 0.53;
p
= 0.024) and Δsystolic blood pressure (β = 0.62;
p
= 0.017), and %excess BMI loss (
β
= − 0.004;
p
= 0.018) were associated with ΔeGFRcyst-creat. There was no significant change in NDS, VPT, CPT, WPT, NCS, uACR or retinopathy status. Glomerular hyperfiltration resolved in 42% of the 12 patients with this condition pre-operatively.
Conclusion
Bariatric surgery results in improvements in small nerve fibres and glomerular hyperfiltration in obese people with T2D, which were associated with weight loss, triglycerides and systolic blood pressure, but with no change in retinopathy or uACR at 12 months.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33104989</pmid><doi>10.1007/s11695-020-05052-8</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8004-1897</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Obesity surgery, 2021-02, Vol.31 (2), p.554-563 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Bariatric Surgery Blood pressure Cohort analysis Diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - surgery Diabetic Neuropathies - etiology Diabetic neuropathy Female Gastrointestinal surgery Humans Male Medicine Medicine & Public Health Middle Aged Obesity, Morbid - surgery Original Contributions Prospective Studies Surgery Triglycerides |
| title | Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study |
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