Anti-Inflammatory effects of 2-week high protein dietary intervention in morbidly obese patients with Type 2 Diabetes Mellitus undergoing Roux-en-Y Gastric Bypass Surgery

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 695-707-Obesity Treatment
Clinical
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-700
Scott Monte*1, Husam Ghanim2, Joseph Caruana1, Sanaa Abuaysheh1, Kelly Green1 and Paresh Dandona3
1SUNY at Buffalo, 2SUNY at Buffalo, Buffalo, NY, 3State Univ of NY, Buffalo, NY
We have shown previously that weight loss and the resolution of insulin resistance
following Roux-en-Y gastric bypass (RYGB) is accompanied by reduction in
endotoxemia, toll-like receptor (TLR) expression, and proinflammatory mediators.
Because it is known that RYGB limits carbohydrate and fat intake it is
plausible that a higher protein and fat deprived diet may contribute to these
effects. This study aims to evaluate the effect of a 2-week high protein, low
carbohydrate and fat deprived diet intervention on inflammation and insulin
resistance preceding RYGB. Ten adults with morbid obesity and T2DM undergoing
RYGB were studied over a 2-week normal diet control period and 2-week dietary
intervention immediately preceding RYGB. During diet intervention, subjects were given four liquid shakes
(with or without skim milk), each containing 7g carbohydrate, 0g fat, and 27g of protein, for daily total intake of 550-785
calories. Fasting blood samples were obtained at start of control period,
before diet intervention, and at day of surgery. Following the high protein
diet intervention subjects had a significant reduction in weight by 6.0±0.4 %,
glucose by11±3% and insulin by 48±9% and HOMA-IR by 61±14%. Free fatty acid concentrations
increased significantly by 58±18%. The mRNA expression of TLR-2 and SOCS-3 in mononuclear
cells (MNC) was reduced by 15±5% and 29±9%, respectively. Plasma concentrations
of endotoxin, MMP-9 and ICAM-1 fell following the dietary intervention by 16±4%,
11±3% and 22±7%, respectively. There was no change in TLR-4 and CD14 expression
or in plasma MCP-1. There was no significant change in these indices after 2
weeks of the normal diet period. The 2-week high protein, low carbohydrate, fat
deprived diet intervention preceding RYGB effectively reduces weight, insulin
resistance, and proinflammatory mediators in spite of the increase in FFA
concentrations.

Nothing to Disclose: SM, HG, JC, SA, KG, PD

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm