Endotoxin and Intestinal Flora Before and After Gastric Bypass or Banding in Diabetics

NCT00960765 — Completed, 15 participants, CPL Associates

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Comparison Of Endotoxin Concentration And Intestinal Microbiologic Flora Before And After Roux-En-Y Gastric Bypass Or Gastric Banding Surgery In Morbidly Obese Patients With Type 2 Diabetes Mellitus

RegistryNCT00960765
StatusCompleted
Study typeObservational
Enrollment15 (Actual)
SponsorCPL Associates (Other); collaborators: Synergy Bariatrics, Sisters of Charity Hospital, The New York State Center of Excellence in Bioinformatics & Life Sciences
ConditionsObesity, Morbid, Diabetes Mellitus, Type 2, Gastric Bypass
Datesstart 2009-08-01, primary completion 2015-04-01, completion 2015-04-01, first posted 2009-08-18, last updated 2016-01-28
Locations2 sites in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Obesity, Morbid All trials for Diabetes Mellitus, Type 2

-Summary

This research project is designed to investigate endotoxin (a toxin present in the wall of certain kinds of bacteria) levels and the type of bacteria present in the intestine before and after Roux-en-Y gastric bypass or gastric banding surgery in patients that meet the classification for morbid obesity (body mass index >40 kg/m2) and type 2 diabetes. It is known that the type of bacteria present in the intestines of normal weight and obese individuals are different, and it is also known that people with obesity and type 2 diabetes have higher levels of endotoxin. It has been shown that the bacteria change over the long run after Roux-en-Y gastric bypass surgery, but the short-term effects are not known and the endotoxin levels after this procedure have never been studied.

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+Detailed description

Evidence exists that (i) morbidly obese, T2D patients undergoing RYGB are highly likely to resolve T2D symptoms or dramatically reduce oral and/or insulin requirements, (ii) metabolic endotoxemia may incite the pathologic conditions of low-grade inflammation and subsequently insulin resistance, obesity and T2D, (iii) significant intestinal microbiologic flora differences exist between normal weight and obese/diabetic individuals, and (iv) RYGB alters long-term intestinal microbiologic flora. Therefore, it is logical to evaluate short- and long-term circulating endotoxin concentrations and intestinal microbiologic flora in context with weight loss and restoration of euglycemia to expand our knowledge of the mechanism of the benefits observed following RYGB.

+Arms and interventions

ArmTypeInterventionsDescription
Roux-En-Y Gastric Bypass
Gastric Banding
Sucessful Response to RYGB
Failed Response to RYGB

+Eligibility

Sex: All, ages: 18 Years to 95 Years

Inclusion Criteria:

* Age > 18 years of age
* Morbid obesity (BMI > 40 kg/m2)
* Confirmed T2D diagnosis/date of onset

Exclusion Criteria:

* Age < 18 years of age
* BMI < 40 kg/m2
* Type 1 diabetes
* Chronic use of non-steroidal anti-inflammatory agents (NSAIDs)
* Chronic use of systemic corticosteroids
* Anticipated inability to maintain current statin, angiotensin converting enzyme inhibitor (ACEI), or angiotensin receptor blocking agent (ARB) regimen

+Locations (2)

FacilityCityCountryStatus
Sisters of Charity HospitalBuffalo, New YorkUnited States
Synergy BariatricsWilliamsville, New YorkUnited States

+Publications

  • Results publication: Dandona P, Ghanim H, Monte SV, Caruana JA, Green K, Abuaysheh S, Lohano T, Schentag J, Dhindsa S, Chaudhuri A. Increase in the mediators of asthma in obesity and obesity with type 2 diabetes: reduction with weight loss. Obesity (Silver Spring). 2014 Feb;22(2):356-62. doi: 10.1002/oby.20524. Epub 2013 Sep 4. PMID 23804543
  • Results publication: Ghanim H, Monte SV, Sia CL, Abuaysheh S, Green K, Caruana JA, Dandona P. Reduction in inflammation and the expression of amyloid precursor protein and other proteins related to Alzheimer's disease following gastric bypass surgery. J Clin Endocrinol Metab. 2012 Jul;97(7):E1197-201. doi: 10.1210/jc.2011-3284. Epub 2012 Apr 16. PMID 22508715

+Investigators