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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

Akhila Mallipedhi, Thinzar Min, Sarah Prior Orcid Logo, Claire MacIver, Steve D. Luzio, Gareth Dunseath Orcid Logo, Richard Bracken Orcid Logo, Saiful Islam Orcid Logo, Jonathan D. Barry, Scott Caplin, Jeffrey Stephens Orcid Logo, Steve Luzio Orcid Logo

Metabolism

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

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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. 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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 Steve Luzio Steve Luzio true false 2015-08-27 BMS 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 Biomedical Sciences COLLEGE CODE BMS Swansea University 2016-03-31T15:52:52.0998225 2015-08-27T12:53:27.1702900 Faculty of Medicine, Health and Life Sciences 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 Steve 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
Steve 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_***_Steve Luzio
author Sarah Prior
Gareth Dunseath
Richard Bracken
Saiful Islam
Jeffrey Stephens
Steve Luzio
author2 Akhila Mallipedhi
Thinzar Min
Sarah Prior
Claire MacIver
Steve D. Luzio
Gareth Dunseath
Richard Bracken
Saiful Islam
Jonathan D. Barry
Scott Caplin
Jeffrey Stephens
Steve Luzio
format Journal article
container_title Metabolism
publishDate 2015
institution Swansea University
doi_str_mv 10.1016/j.metabol.2015.08.009
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
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 2015-12-31T03:27:14Z
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