Improvements in diabetic neuropathy and nephropathy after bariatric surgery: a prospective cohort study
Authors
Adam, SafwaanAzmi, S.
Ho, J. H.
Liu, Y.
Ferdousi, M.
Siahmansur, T.
Kalteniece, A.
Marshall, A.
Dhage, Shaishav
Iqbal, Z.
D'Souza, Y.
Natha, S.
Kalra, P. A.
Donn, R.
Ammori, B. J.
Syed, A. A.
Durrington, P. N.
Malik, R. A.
Soran, H.
Affiliation
Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.Issue Date
2020
Metadata
Show full item recordAbstract
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/m2; p < 0.001) decreased post-operatively. There were improvements in CNFD (27.1 to 29.2/mm2; p = 0.005), CNBD (63.4 to 77.8/mm2; p = 0.008), CNFL (20.0 to 20.2/mm2; 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.Citation
Adam S, Azmi S, Ho JH, Liu Y, Ferdousi M, Siahmansur T, et al. Improvements in Diabetic Neuropathy and Nephropathy After Bariatric Surgery: a Prospective Cohort Study. Obes Surg. 2020.Journal
Obesity SurgeryDOI
10.1007/s11695-020-05052-8PubMed ID
33104989Additional Links
https://dx.doi.org/10.1007/s11695-020-05052-8Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1007/s11695-020-05052-8
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