Muscle and adipose tissue morphology, insulin sensitivity and beta-cell function in diabetic and nondiabetic obese patients: effects of bariatric surgery.
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Abstract Obesity is characterized by insulin-resistance (IR), enhanced lipolysis, and ectopic, inflamed fat. We related the histology of subcutaneous (SAT), visceral fat (VAT), and skeletal muscle to the metabolic abnormalities, and tested their mutual changes after bariatric surgery in type 2 diabetic (T2D) and weight-matched non-diabetic (ND) patients. We measured IR (insulin clamp), lipolysis (2H5-glycerol infusion), ß-cell glucose-sensitivity (ß-GS, mathematical modeling), and VAT, SAT, and rectus abdominis histology (light and electron microscopy). Presurgery, SAT and VAT showed signs of fibrosis/necrosis, small mitochondria, free interstitial lipids, thickened capillary basement membrane. Compared to ND, T2D had impaired ß-GS, intracapillary neutrophils and higher intramyocellular fat, adipocyte area in VAT, crown-like structures (CLS) in VAT and SAT with rare structures (cyst-like) ~10-fold larger than CLS. Fat expansion was associated with enhanced lipolysis and IR. VAT histology and intramyocellular fat were related to impaired ß-GS. Postsurgery, IR and lipolysis improved in all, ß-GS improved in T2D. Muscle fat infiltration was reduced, adipocytes were smaller and richer in mitochondria, and CLS density in SAT was reduced. In conclusion, IR improves proportionally to weight loss but remains subnormal, whilst SAT and muscle changes disappear. In T2D postsurgery, some VAT pathology persists and beta-cell dysfunction improves but is not normalized.
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AT content and function are likely further altered in patients with T2DM compared with obese individuals with the same BMI.
“is likely to be further altered in patients with T2DM compared with obese individuals with the same BMI”
From Effect of Exercise Training on Fat Loss—Energetic Perspectives and the Role of Improved Adipose Tissue Function and Body Fat Distribution (2021) · cites this paper as Camastra et al., 2017
The Methods (Subjects) describe BMI-matched T2D and nondiabetic obese groups. The Results (Light microscopy) and Discussion report greater visceral adipose-tissue enlargement and inflammatory changes in the T2D group. The cited passages do not establish that adipose-tissue function itself was further impaired in T2D than in the BMI-matched group. (LLM, conf=0.82)
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- Authors
- Camastra, S., Vitali, A., Anselmino, M., Gastaldelli, A., Bellini, R., Berta, R., Severi, I., Baldi, S., Astiarraga, B., Barbatelli, G., Cinti, S., & Ferrannini, E.
- Affiliations
- University of Pisa (IT)
- Istituto di Fisiologia Clinica (IT)
- Corresponding author
- Camastra, Stefania
- ORCID
- Venue
- Scientific Reports
- Published
- 2017-08-21
- Volume
- 7
- Issue
- 1
- Pages
- 9007-9007
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5566429
- OpenAlex
- W2750564155
- Cited by
- 93
- References
- 45
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 9 · 2023: 13 · 2022: 11 · 2021: 21 · 2020: 6 · 2019: 10 · 2018: 9 · 2017: 2
- FWCI
- 7.56
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-05-22)
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
- Funders
- European Commission (278373, 241762)
- Ministero della Salute
- Ministero dell’Istruzione, dell’Università e della Ricerca (MIUR 2010329EKE, 2010329EKE)
- Università di Pisa
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology › Adipose Tissue and Metabolism
- Keywords
- obesity, type 2 diabetes, bariatric surgery, insulin resistance, beta-cell function, adipose tissue histology, subcutaneous adipose tissue, visceral fat, skeletal muscle, intramyocellular lipid, lipolysis, crown-like structures, fat necrosis, mitochondrial dysfunction, weight loss, adipocyte size
- MeSH terms
- Adipose Tissue, Adult, Diabetes Mellitus, Type 2, Female, Histocytochemistry, Humans, Insulin Resistance, Male, Middle Aged, Muscles, Obesity, Treatment Outcome, Bariatric Surgery, Insulin-Secreting Cells
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