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Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery / Sarah, Prior; Gareth, Dunseath; Richard, Bracken; Saiful, Islam; Jeffrey, Stephens; Stephen, Luzio

Metabolism

Swansea University Authors: Sarah, Prior, Gareth, Dunseath, Richard, Bracken, Saiful, Islam, Jeffrey, Stephens, Stephen, Luzio

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DOI (Published version): 10.1016/j.metabol.2015.08.009

Abstract

Background and AimsBariatric surgery results in the remission of type 2 diabetes mellitus (T2DM) in morbidly obese subjects. The aim of the study was to investigate the predictive value of both static and dynamic measures of C-peptide in relation to T2DM resolution 6 months after bariatric surgery r...

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Published in: Metabolism
Published: 2015
URI: https://cronfa.swan.ac.uk/Record/cronfa22971
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The aim of the study was to investigate the predictive value of both static and dynamic measures of C-peptide in relation to T2DM resolution 6 months after bariatric surgery regardless of the operation type.Methods and ResultsA non-randomized prospective study of 24 participants with T2DM undergoing bariatric surgery. Measurements of fasting and 2-hour plasma glucose, insulin, C-peptide and measures of insulin sensitivity were recorded temporally during an oral glucose tolerance test pre-operatively and 6 months post-operatively. A responder was defined with a fasting glucose &amp;#60; 5.6mmol/L and HBA1c &amp;#60; 6.0% postoperatively. Within the sample there were 11 responders and 13 non-responders at 6 months. There was a significant difference in the duration of diabetes between the groups. Fasting C-peptide (P&#x2264;0.05) and 2-hour C-peptide (P&#x2264;0.05) were higher in responders compared to non-responders. Significantly higher C-peptide levels were observed preoperatively at all time points for responders, with significantly higher area under the curve (AUC0&#x2013;60 and AUC0&#x2013;120). Using the lower quartiles for C-peptide levels, both fasting C-peptide (&amp;#62; 2.5ng/mL [0.83nmol/L]) and 2-hour C-peptide (&amp;#62; 5.2ng/mL [1.73nmol/L]) had a sensitivity and negative predictive value of 100% to predict T2DM remission. Logistic regression showed C-peptide, duration of diabetes and BMI were associated with response. The area under the ROC curve was 0.94 and a regression model predicted diabetes remission with a sensitivity of 85.7% and a specificity of 88.9%.ConclusionsThis study demonstrated that static (fasting) and dynamic (AUC, 2-hour) C-peptide measurements predict T2DM resolution 6 months following bariatric surgery. This work provides insight into C-peptide dynamics as a predictor of response to bariatric surgery.</abstract><type>Journal Article</type><journal>Metabolism</journal><publisher/><keywords/><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2015</publishedYear><publishedDate>2015-12-31</publishedDate><doi>10.1016/j.metabol.2015.08.009</doi><url/><notes></notes><college>COLLEGE NANME</college><department>Medicine</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution>Swansea University</institution><lastEdited>2016-03-31T15:52:52.0998225</lastEdited><Created>2015-08-27T12:53:27.1702900</Created><path><level id="1">Swansea University Medical School</level><level id="2">Medicine</level></path><authors><author><firstname>Akhila</firstname><surname>Mallipedhi</surname><order>1</order></author><author><firstname>Thinzar</firstname><surname>Min</surname><order>2</order></author><author><firstname>Sarah</firstname><surname>Prior</surname><orcid>0000-0001-8703-8092</orcid><order>3</order></author><author><firstname>Claire</firstname><surname>MacIver</surname><order>4</order></author><author><firstname>Steve D.</firstname><surname>Luzio</surname><order>5</order></author><author><firstname>Gareth</firstname><surname>Dunseath</surname><orcid>0000-0001-6022-862X</orcid><order>6</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>7</order></author><author><firstname>Saiful</firstname><surname>Islam</surname><orcid>0000-0003-3182-8487</orcid><order>8</order></author><author><firstname>Jonathan D.</firstname><surname>Barry</surname><order>9</order></author><author><firstname>Scott</firstname><surname>Caplin</surname><order>10</order></author><author><firstname>Jeffrey</firstname><surname>Stephens</surname><orcid>0000-0003-2228-086X</orcid><order>11</order></author><author><firstname>Stephen</firstname><surname>Luzio</surname><orcid>0000-0002-7206-6530</orcid><order>12</order></author></authors><documents><document><filename>0022971-31032016155212.pdf</filename><originalFilename>MallipedhiAssociationBetweenThePreoperative2015AM.pdf</originalFilename><uploaded>2016-03-31T15:52:12.7070000</uploaded><type>Output</type><contentLength>603586</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><action/><embargoDate>2016-08-19T00:00:00.0000000</embargoDate><documentNotes>&#xA9; 2016. 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spelling 2016-03-31T15:52:52.0998225 v2 22971 2015-08-27 Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery cdda101035997acfaa6fdf17097f52b2 0000-0001-8703-8092 Sarah Prior Sarah Prior true false fccbba9edcaee08a839a3c5cff8cbe19 0000-0001-6022-862X Gareth Dunseath Gareth Dunseath true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 4157d27b800a8357873bdfc9c71bd596 0000-0003-3182-8487 Saiful Islam Saiful Islam true false 5219d126f97f8f884bdb622099bd41de 0000-0003-2228-086X Jeffrey Stephens Jeffrey Stephens true false 01491e1cd582746a654fad9addf0de16 0000-0002-7206-6530 Stephen Luzio Stephen Luzio true false 2015-08-27 PMSC Background and AimsBariatric surgery results in the remission of type 2 diabetes mellitus (T2DM) in morbidly obese subjects. The aim of the study was to investigate the predictive value of both static and dynamic measures of C-peptide in relation to T2DM resolution 6 months after bariatric surgery regardless of the operation type.Methods and ResultsA non-randomized prospective study of 24 participants with T2DM undergoing bariatric surgery. Measurements of fasting and 2-hour plasma glucose, insulin, C-peptide and measures of insulin sensitivity were recorded temporally during an oral glucose tolerance test pre-operatively and 6 months post-operatively. A responder was defined with a fasting glucose &#60; 5.6mmol/L and HBA1c &#60; 6.0% postoperatively. Within the sample there were 11 responders and 13 non-responders at 6 months. There was a significant difference in the duration of diabetes between the groups. Fasting C-peptide (P≤0.05) and 2-hour C-peptide (P≤0.05) were higher in responders compared to non-responders. Significantly higher C-peptide levels were observed preoperatively at all time points for responders, with significantly higher area under the curve (AUC0–60 and AUC0–120). Using the lower quartiles for C-peptide levels, both fasting C-peptide (&#62; 2.5ng/mL [0.83nmol/L]) and 2-hour C-peptide (&#62; 5.2ng/mL [1.73nmol/L]) had a sensitivity and negative predictive value of 100% to predict T2DM remission. Logistic regression showed C-peptide, duration of diabetes and BMI were associated with response. The area under the ROC curve was 0.94 and a regression model predicted diabetes remission with a sensitivity of 85.7% and a specificity of 88.9%.ConclusionsThis study demonstrated that static (fasting) and dynamic (AUC, 2-hour) C-peptide measurements predict T2DM resolution 6 months following bariatric surgery. This work provides insight into C-peptide dynamics as a predictor of response to bariatric surgery. Journal Article Metabolism 31 12 2015 2015-12-31 10.1016/j.metabol.2015.08.009 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2016-03-31T15:52:52.0998225 2015-08-27T12:53:27.1702900 Swansea University Medical School Medicine Akhila Mallipedhi 1 Thinzar Min 2 Sarah Prior 0000-0001-8703-8092 3 Claire MacIver 4 Steve D. Luzio 5 Gareth Dunseath 0000-0001-6022-862X 6 Richard Bracken 0000-0002-6986-6449 7 Saiful Islam 0000-0003-3182-8487 8 Jonathan D. Barry 9 Scott Caplin 10 Jeffrey Stephens 0000-0003-2228-086X 11 Stephen Luzio 0000-0002-7206-6530 12 0022971-31032016155212.pdf MallipedhiAssociationBetweenThePreoperative2015AM.pdf 2016-03-31T15:52:12.7070000 Output 603586 application/pdf Accepted Manuscript true 2016-08-19T00:00:00.0000000 © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ true
title Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
spellingShingle Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
Sarah, Prior
Gareth, Dunseath
Richard, Bracken
Saiful, Islam
Jeffrey, Stephens
Stephen, Luzio
title_short Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
title_full Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
title_fullStr Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
title_full_unstemmed Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
title_sort Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
author_id_str_mv cdda101035997acfaa6fdf17097f52b2
fccbba9edcaee08a839a3c5cff8cbe19
f5da81cd18adfdedb2ccb845bddc12f7
4157d27b800a8357873bdfc9c71bd596
5219d126f97f8f884bdb622099bd41de
01491e1cd582746a654fad9addf0de16
author_id_fullname_str_mv cdda101035997acfaa6fdf17097f52b2_***_Sarah, Prior
fccbba9edcaee08a839a3c5cff8cbe19_***_Gareth, Dunseath
f5da81cd18adfdedb2ccb845bddc12f7_***_Richard, Bracken
4157d27b800a8357873bdfc9c71bd596_***_Saiful, Islam
5219d126f97f8f884bdb622099bd41de_***_Jeffrey, Stephens
01491e1cd582746a654fad9addf0de16_***_Stephen, Luzio
author Sarah, Prior
Gareth, Dunseath
Richard, Bracken
Saiful, Islam
Jeffrey, Stephens
Stephen, Luzio
format Journal article
container_title Metabolism
publishDate 2015
institution Swansea University
doi_str_mv 10.1016/j.metabol.2015.08.009
college_str Swansea University Medical School
hierarchytype
hierarchy_top_id swanseauniversitymedicalschool
hierarchy_top_title Swansea University Medical School
hierarchy_parent_id swanseauniversitymedicalschool
hierarchy_parent_title Swansea University Medical School
department_str Medicine{{{_:::_}}}Swansea University Medical School{{{_:::_}}}Medicine
document_store_str 1
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description Background and AimsBariatric surgery results in the remission of type 2 diabetes mellitus (T2DM) in morbidly obese subjects. The aim of the study was to investigate the predictive value of both static and dynamic measures of C-peptide in relation to T2DM resolution 6 months after bariatric surgery regardless of the operation type.Methods and ResultsA non-randomized prospective study of 24 participants with T2DM undergoing bariatric surgery. Measurements of fasting and 2-hour plasma glucose, insulin, C-peptide and measures of insulin sensitivity were recorded temporally during an oral glucose tolerance test pre-operatively and 6 months post-operatively. A responder was defined with a fasting glucose &#60; 5.6mmol/L and HBA1c &#60; 6.0% postoperatively. Within the sample there were 11 responders and 13 non-responders at 6 months. There was a significant difference in the duration of diabetes between the groups. Fasting C-peptide (P≤0.05) and 2-hour C-peptide (P≤0.05) were higher in responders compared to non-responders. Significantly higher C-peptide levels were observed preoperatively at all time points for responders, with significantly higher area under the curve (AUC0–60 and AUC0–120). Using the lower quartiles for C-peptide levels, both fasting C-peptide (&#62; 2.5ng/mL [0.83nmol/L]) and 2-hour C-peptide (&#62; 5.2ng/mL [1.73nmol/L]) had a sensitivity and negative predictive value of 100% to predict T2DM remission. Logistic regression showed C-peptide, duration of diabetes and BMI were associated with response. The area under the ROC curve was 0.94 and a regression model predicted diabetes remission with a sensitivity of 85.7% and a specificity of 88.9%.ConclusionsThis study demonstrated that static (fasting) and dynamic (AUC, 2-hour) C-peptide measurements predict T2DM resolution 6 months following bariatric surgery. This work provides insight into C-peptide dynamics as a predictor of response to bariatric surgery.
published_date 2015-12-31T03:40:30Z
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