Obesity associated blunted subcutaneous adipose tissue blood flow after meal is improved after bariatric surgery

Background and aims: GIP and meal ingestion increase subcutaneous adipose tissue (SAT) perfusion in healthy subjects. Effects of GIP and meal on visceral adipose tissue (VAT) perfusion is unclear. Our aim was to investigate the effects of meal and GIP on VAT and SAT perfusion in obese subjects with type 2 diabetes (T2DM) before and after bariatric surgery.Materials and methods: We recruited 10 obese subjects with T2DM scheduled for bariatric surgery and 10 control subjects. Subjects were studied under two stimulations: meal ingestion and GIP infusion. SAT and VAT perfusion was measured using 15O-H2O PET-MRI at three time points: baseline, 20min and 50min after start of stimulation. Obese subjects were studied before and after bariatric surgery.Results: Before bariatric surgery the responses of SAT perfusion to meal (p=0.04) and GIP-infusion (p=0.002) were blunted in the obese subjects compared to the controls. VAT perfusion response did not differ between obese and control subjects after meal or GIP-infusion.After bariatric surgery SAT perfusion response to meal was similar to that of control subjects. SAT perfusion response to GIP administration remained lower in operated than control subjects. There was no change in VAT perfusion response after bariatric surgery.Conclusions: The vasodilating effects of GIP and meal are blunted in SAT but not in VAT in obese subjects with T2DM. Bariatric surgery improves the effects of meal on SAT perfusion, but not the effects of GIP. Postprandial increase in SAT perfusion after bariatric surgery seems to be regulated in a GIP independent manner.