Abstract
ObjectiveTo assess the influence of bariatric surgery on transcription factor 7-like 2 (TCF7L2) expression and its association with body mass index (BMI) and Type 2 diabetes mellitus (T2DM).MethodsProspective study performed between 2016 and 2018, where 26 obese patients undergoing bariatric surgery were divided into two subgroups: diabetics and non-diabetics. The RNAs were extracted from peripheral blood samples that were obtained from each patient in two different moments: before surgery and after 12 months of follow-up. The relative expression of TCF7L2 was determined according to the delta-Ct method.ResultsThe linear regression model of BMI x delta-Ct showed a positive correlation (p = 0.037). In the subgroups, an inversely proportional relationship was found between delta-Ct and BMI in the diabetic group and a directly proportional relationship in the non-diabetic group (p>0.05 in both). In the postoperative period, the regression model was similar to the preoperative, except when analyzing the subgroups, where diabetic patients showed a directly proportional relationship (p>0.05). The relative expression of TCF7L2 showed an average of 1.16 ± 0.91, CI-95% 0.79–1.53. There was an increase in relative expression of 48% in the non-diabetic group (p = 0.021), and a decrease of 27% in the T2DM group (p>0.05) in the postoperative. There was a positive correlation between a greater decrease in BMI and increased relative expression (p = 0.027).ConclusionOur results showed that generally, the TCF7L2 expression increase with a decrease in BMI, however, for patients with T2DM, it exhibits an inverse pattern, which is normalized one year after bariatric surgery.
Highlights
The transcription factor 7-like 2 (TCF7L2) belongs to a family of transcription factors that regulates several embryonic development processes and affects several cell lines and organs in adult individuals [1]
There was an increase in relative expression of 48% in the non-diabetic group (p = 0.021), and a decrease of 27% in the Type 2 diabetes mellitus (T2DM) group (p>0.05) in the postoperative
Our results showed that generally, the TCF7L2 expression increase with a decrease in body mass index (BMI), for patients with T2DM, it exhibits an inverse pattern, which is normalized one year after bariatric surgery
Summary
The transcription factor 7-like 2 (TCF7L2) belongs to a family of transcription factors that regulates several embryonic development processes and affects several cell lines and organs in adult individuals [1]. A strong association was reported between the polymorphisms of TCF7L2 gene and risk for T2DM, with a population risk of 21% associated to TCF7L2 [3,4,5,6]. Hindle et al investigated TCF7L2 expression in obese patients who underwent bariatric surgery, analyzing its relationship with the BMI of the study population and later in subgroups of patients according to the presence or absence of T2DM. The referred study and other subsequent studies have aroused questioning on the role of the change in TCF7L2 expression in solving resolution of obesity and diabetes observed after bariatric surgery, as well as on the possible relationship between gene expression and BMI and on whether such expression can be affected by the presence or absence of T2DM [8,9,10,11]
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