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RYGB and oxidative stress

RYGB reduces oxidative stress in subcutaneous tissue

Post-surgery, AMPK activity increased 3.5-fold and oxidative stress decreased by 50% in subcutaneous adipose tissue

According to a study, ‘Improved insulin sensitivity 3 months after RYGB surgery is associated with increased subcutaneous adipose tissue AMPK activity and decreased oxidative stress., published in Diabetes, roux-en-Y gastric bypass (RYGB) surgery attenuates markers of oxidative stress in subcutaneous adipose tissue.

It is known that morbidly obese individuals are predisposed to a wide range of disorders including type 2 diabetes, atherosclerotic cardiovascular disease (ASCVD), fatty liver disease, and certain cancers, and that decreased AMP-activated protein kinase (AMPK) activity, together with increased oxidative stress and inflammation in adipose tissue, are associated with insulin resistance in morbidly obese bariatric surgery patients.

In this study, the researchers assessed how these parameters are affected by RYGB surgery. Eleven patients (average age of 46 ± 4 years) were studied immediately prior to and three months post-operatively. The researchers measured subcutaneous adipose tissue AMPK phosphorylation (Threonine 172, an index of its activation), malonyl-CoA content, protein carbonylation (a marker of oxidative stress), plasma adiponectin, and mRNA expression of several inflammatory cytokines.

They report that post-surgery, AMPK activity increased 3.5-fold and oxidative stress decreased by 50% in subcutaneous adipose tissue. In addition, malonyl-CoA levels were reduced by 80%. Furthermore, they also noted that patients had improvements in their BMI, insulin sensitivity (HOMA), and increased circulating high molecular weight (HMW) adiponectin, as well as decreased fasting plasma insulin levels.

In contrast, the expression of inflammatory markers in subcutaneous adipose tissue was unchanged post-operatively, although plasma CRP was diminished by 50%.

"Bariatric surgery has been demonstrated to attenuate markers of oxidative stress in liver and plasma," write the authors from the Boston University School of Medicine. "The results of the present study indicate that it has a similar effect in subcutaneous adipose tissue."

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