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Aims Increasing evidence implicates the microbiome as a susceptibility factor for ischaemic stroke (IS). Interpretation of this evidence is difficult, for the composition of the microbiome is influenced by various factors and might affect differently in IS subtypes. We aim to determine if the specific gut microbiome is causally associated with IS subtypes and suggest potential approaches for stroke prevention. Methods and results We conducted a two-sample Mendelian randomization (MR) analysis to test the causal relationship between gut microbiome and IS subtypes. For exposure data, we extracted genetic variants associated with 194 bacterial traits from MiBioGen consortium (n = 18 340). For outcomes, we selected three IS subtypes including cardioembolic stroke (CES, n = 410 484), small vessel stroke (SVS, n = 198 048), and large artery stroke (LAS, n = 198 048). Additionally, we performed a sequence of sensitivity analyses to validate preliminary MR results. There were four, three, and four bacteria showing an increased risk for LAS, SVS, and CES, respectively, and there were five, six, and five bacteria leading a decreasing risk for LAS, SVS, and CES, respectively. Amongst these, the genus_Intestinimonas showed negative associations with LAS [odds ratio (OR) = 0.77, 95% confidence interval (CI) (0.61–0.98)] and SVS (0.85, 0.73–0.98). The genus_LachnospiraceaeNK4A136group was genetically associated with decreased risk of both SVS (0.81, 0.66–0.99) and CES (0.75, 0.60–0.94). Conclusion The study revealed the causal effect of the abundance of specific bacterial features on the risk of IS subtypes. Notably, genus_Intestinimonas and genus_LachnospiraceaeNK4A136group displayed significant protection against more than one IS subtype, further suggesting potential applications of targeted probiotics in IS prevention.

Context The association between visceral adipose tissue (VAT) and pre-eclampsia (PE) shows inconsistent results and the underlying mediator remains unknown. Objective We aimed to explore the causal effect of VAT on PE risks and the mediation role of age at menarche (AAM) in explaining this relationship. Methods Summary data for PE were obtained from the FinnGen genome-wide association study (3556 cases and 114 735 controls). For exposure data, 70 genetic variants associated with the predicted VAT in 161 149 European women from UK Biobank were used as instrumental variables. Inverse variance weighted and multiple sensitivity analyses were applied. We also conducted multivariable Mendelian randomization (MR) analyses to test the association between VAT-associated single-nucleotide variations and PE. Next, mediation analyses were performed to study whether the association between VAT and PE was mediated via AAM. Results In univariable MR analysis, higher volume of VAT was associated with the advancement of AAM and increased PE risk (beta = −0.33; 95% CI, −0.49 to −0.16 for AAM; odds ratio 1.65, 95% CI, 1.23 to 2.20 for PE). After adjusting for waist circumference, waist to hip ratio, and hip circumference, the multivariable MR results presented the consistent positive causality of VAT on PE. Two-step MR analysis proved an estimated 14.3% of the positive effect of VAT on PE was mediated by AAM. Conclusion Our findings provided evidence of the causal relationship between VAT and PE and proved VAT could accelerate AAM and then contribute to the risk of incident PE.

To study the mechanism of circular ribonucleic acid (RNA) circHIPK3 involved in the resistance of lung cancer cells to gefitinib, 110 patients with lung cancer were recruited as the research objects, and the tumor tissue and para-cancerous tissue of each patient’s surgical specimens were collected and paraffinized to detect the expression of circHIPK3 in different tissues. Gefitinib drug-resistant cell line of lung cancer was constructed with gefitinib to detect cell apoptosis under different conditions. As a result, the relative expression of circHIPK3 in patients with tumor diameter no less than 3 cm was dramatically inferior to that in patients with tumor diameter less than 3 cm ( P < 0.05 ). The relative expression of circHIPK3 in patients with TNM stage II/III was dramatically inferior to that in patients with tumor, node, and metastasis (TNM) stage I ( P < 0.05 ). Expression of circHIPK3 in patients with lymph node metastasis was dramatically inferior to that in patients without lymph node metastasis ( P < 0.05 ). Of the lung cancer tissues of patients with different TNM stages, only six patients had high expression, and the remaining 104 patients had low expression. Moreover, electrophoresis revealed that circHIPK3 can only be amplified in cDNA, but not in gDNA. Gefitinib-mediated apoptosis rate of lung cancer drug-resistant cell lines decreased notably. In summary, the circular RNA circHIPK3 may have a notably low expression in lung cancer tissues, whose low expression had a certain enhancement effect on the drug resistance of lung adenocarcinoma cells to gefitinib.

Damage of Intestinal Stem Cells (ISCs) is the main cause of radiation induced-intestinal injury (RIII). Recently, hypoxia Inducible factor (HIF) was verified to be critical for promoting proliferation of ISCs, which suggested a protective role of HIF in the RIII. Thus, we investigated the effect of FG-4592, a novel up-regulator of HIF, on the protection of RIII. With/without FG-4592 treatment, the abdomen of mice was radiated, and intestinal injury was assessed. Especially, by intestinal organoid culture, the multiplication capacity and differentiation features of ISCs were detected. As a result, FG-4592, a novel up-regulator of HIF could remit RIII and promote regeneration and differentiation of ISCs after radiation, which were depended on HIF-2 rather than HIF-1.

The tree shrew (Tupaia belangeri) is currently placed in the order Scandentia. Owing to their unique characteristics, such as small body size, high brain-to-body mass ratio, short reproductive cycle and life span, and low maintenance costs in laboratory conditions, tree shrews have been proposed as alternative experimental animals to primates in biomedical research. In this study, we determined the complete mitochondrial genome of the subspecies Tupaia belangeri yaoshanensis (T.b. yaoshanensis). The mitochondrial DNA (mtDNA) is 16,777 bp long and contains 13 protein-coding genes (PCGs), two ribosomal RNA genes (12S and 16S), and 22 transfer RNA (tRNA) genes. The base composition of the mitogenome was A (32.28%), T (26.82%), G (14.79%), and C (26.11%). For the 13 PCGs, 1405 variable sites were found between T.b. yaoshanensis and T.b. chinensis (JN800724), of which 916 were synonymous and 489 were nonsynonymous. The frequency of mutations significantly varied among the different genes, with the highest value in the mt-NAD5 gene of tree shrews. Phylogenetic analysis based on the amino acid sequences of 13 PCGs revealed a closer relationship between the species of Scandentia and Lagomorpha. To the best of our knowledge, this is the first study to report the complete mitochondrial genome sequence of T.b. yaoshanensis.

Background Despite the established association between obesity and cancer risk, it remains unclear whether visceral obesity is causally related to cancer risk and whether it is more pro-oncogenic than total body fat. Methods We conducted two-sample Mendelian randomization (MR) analysis to assess the causal effects of visceral adipose tissue (VAT) on six common cancers. For exposure data, 221 genetic variants associated with the predicted volume of VAT in 325 153 Europeans from UK Biobank were used as instrumental variables. Genetic association data of six common cancers (breast, lung, colorectal, ovarian, pancreatic and prostate cancers) were obtained from large-scale consortia with an average of 19 576 cases and 43 272 controls. We performed univariable MR with five MR methods [inverse-variance weighted (IVW), MR-Egger regression, weighted median, MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO) and Radial MR] and multivariable MR to estimate the effect of VAT independent of body mass index (BMI). Finally, we performed a series of sensitivity analyses as validation of primary MR results. Results Two associations survived the false discovery rate correction for multiple testing (q-value Conclusion Our findings suggest that lifelong exposure to elevated volumes of VAT might increase the risk of pancreatic cancer and lung squamous-cell carcinoma, highlighting the importance of revealing the underlying mechanisms for intervention targets.

This study clarifies the heat generation and release of a 57.5 Ah HED (266.9 W h kg−1) Li-ion cell with a nickel-rich cathode and SiOx/graphite anode. Significant heat accumulation and delayed heat release effects in large-format cells are uncovered.

Background Previous studies have shown that artificial light at night (ALAN) is associated with obesity in adults or school-aged children, however, without addressing the critical transition period from adolescence to young adulthood. Methods In this study, we recruited incoming students from five geographically dispersed universities across China whose mean ALAN (nanowatts/cm2/sec) during adolescence was obtained using remotely observed nighttime data matched with information on their residence. Body weight and height were measured in a field survey. A mixed generalized linear model assessed the association between ALAN levels and body mass index (BMI). Results A total of 19,344 participants were included with a mean age and BMI of 18.3 ± 0.7 years and 21.2 ± 3.0 kg/m2, respectively. Our findings indicated a significant association between ALAN levels during the past 6 years and BMI (β = 0.1, 95% CI: 0.06–0.14, p

Balanced clustering, which generates clusters of similar sizes, can be useful in a variety of applications. However, existing clustering algorithms either cannot guarantee balanced clustering results or require relatively high time complexities for balanced clustering. In this work, we propose a constrained balanced clustering method, which is referred to as τ-balanced clustering, to generate clusters with a controllable balance degree. The proposed method constrains the cluster sizes in the cluster assignment phase based on an established cluster bound size and an established bound for the number of largest clusters. Second, we optimize the basic τ-balanced clustering method by reducing some unnecessary calculations with two-level filtering. Third, we also design a parallel version for the basic τ-balanced clustering method and the optimized method on GPUs (Graphics Processing Units), to enhance the execution efficiency with high parallelism. Finally, we conduct a series of experiments on nine benchmark datasets to verify the proposed methods. The experimental results show that our methods successfully outperform the state-of-the-art methods.

Metabolic surgery is an effective treatment for type 2 diabetes mellitus (T2DM) in patients with obesity. However, the efficacy in patients with body mass index (BMI) < 32.5 kg/m2, especially in Asian populations, has not been widely reported, and there are few studies on the prediction of diabetes remission. We evaluated 112 patients with T2DM who underwent metabolic surgery between October 2008 and November 2019. The basic data of the patients were collected, and clinical variables were measured at 6 months, 1 year, and 2 years after metabolic surgery. Four independent predictors of surgical outcomes were identified to construct the prediction score. Diabetes remission occurred for 38 of the 112 patients. Ninety patients underwent Roux-en-Y gastric bypass, while the remaining 22 patients underwent sleeve gastrectomy. Weight, glucose, and lipid metabolism parameters were improved significantly after metabolic surgery. Age, BMI, insulin use, and duration were independent predictors of T2DM remission. The above four factors were defined with scores and developed ABID (age, BMI, insulin use, duration) scoring system. Patients with greater ABID scores had a greater probability of diabetes remission (from 0% at score 0 to 100% at score 4). The ABID score is a simple and easy-to-implement prediction score system of diabetes remission after metabolic surgery for T2DM patients with a BMI < 32.5 kg/m2.

Background. The coronavirus disease 2019 (COVID-19) has outbroken into a global pandemic. The death rate for hospital patients varied between 11% and 15%. Although COVID-19 is extremely contagious and has a high fatality rate, the amount of knowledge available in the published literature and public sources is rapidly growing. The efficacy of convalescent plasma (CP) therapy for COVID-19 is controversial. Objective. This meta-analysis was designed to assess the efficacy of CP therapy for COVID-19 through a literature survey. Methods. Until August 30, 2021, a literature search was undertaken in Pubmed, Embase, Web of Science, Cochrane Central Register of Controlling Trials (Central), and China National Knowledge Infrastructure databases. The Risk Ratio (RR) and 95% confidence intervals (CIs) were pooled using a fixed or random effect model in dichotomous data. Mean difference (MD) and 95% confidence intervals (CIs) were pooled using a fixed or random effect model in continuous data. Studies with missing or unsuitable data were presented descriptively in the outcomes. Results. In total, thirteen randomized controlled trials (RCTs) were selected for the present meta-analysis, which included a total of 13232 participants. Our results revealed that the CP group has lower mortality compared to the control group, and there was a statistically significant difference (RR: 0.70, 95% CI: 0.55, 0.89, Z = 2.92, P = 0.004 < 0.01 ); other secondary outcomes such as the shortness of breath symptom improved significantly in CP group (RR:1.48, 95% CI: 1.13, 1.93, Z = 2.85, P = 0.004 < 0.01 ), as well as Interleukin-6 (IL-6) (MD: −4.46, 95% CI: −8.28, −0.63, Z = 2.28, P = 0.02 < 0.05 ) and Ferritin (MD: −447.68, 95% CI: −501.75, −393.6, Z = 16.23, P < 0.00001 ) are reduced significantly in CP group. However, there was no statistically significant change in the ventilator withdrawal rate, imaging results improvement, or days to hospital discharge. There was also no substantial difference in viral nucleic acid negative conversion rate and neutralizing antibody-positive conversion rate, as well as the incidence of adverse reactions. Conclusions. The safety and potential efficacy of convalescent plasma therapy offer a promising treatment strategy for COVID-19. CP therapy can reduce mortality and improve breath and inflammatory cytokines IL-6 and Ferritin in COVID-19 with no significant increase in adverse reactions. However, it does not affect improving virology indicators. In summary, more high-quality clinical trials are needed to verify the conclusion of the present study.

Aims: Current idiopathic pulmonary fibrosis (IPF) therapies usually show a poor outcome or treatment efficacy. The search for new risk factors has significant implications in preventing, delaying, and treating IPF. The association between obesity and the risk of IPF is not clear. This study aimed to investigate the role of different obesity types in IPF risk, which provides the possibility of weight loss as a new approach for IPF prevention.Methods: We conducted a two-sample Mendelian randomization (MR) analysis to assess the causal effect of obesity on IPF risk. We collected summary data of genetically determined obesity-related traits, including body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) from large-scale consortia (the sample size ranging from 232,101 to 681,275), and genetic association with IPF from one of the largest meta-analyses including 2,668 cases. A total of 35–469 single nucleotide polymorphisms were selected as instrumental variables for obesity-related traits. We further performed multivariable MR to estimate the independent effect of BMI and WC on the risk of IPF.Results: Increased BMI and WC were associated with higher risk of IPF [odds ratio (OR) = 1.51, 95% confidence interval (CI) (1.22–1.87), p = 1.27 × 10–4, and OR = 1.71, 95% CI (1.08–2.72), p = 2.33 × 10–2, respectively]. Similar results for the BMI and WC were obtained in the replicated analysis. Subsequently, only the result for BMI survived following the multiple testing correction and showed good consistency with the weighted median estimator. Sensitivity analyses indicated that there was no heterogeneity or horizontal pleiotropy for MR estimations. Further multivariable MR suggested that the BMI showed the same direction and similar magnitude with that in the univariable MR analysis. There was little evidence to support the causal role of WHR on the risk of IPF in this study.Conclusion: Genetically determined BMI demonstrates a causal risk for IPF, which offers a novel insight into probing potential mechanisms. Meanwhile, these results also suggest that weight loss may be beneficial to IPF prevention.

A good combination of strength and fracture toughness is required for aerospace applications of laser additively manufactured (LAM) AerMet100 steel. To understand the role of microstructure in the combination of strength and fracture toughness of LAM AerMet100 steel, microstructures, fracture toughness properties and corresponding crack-tip fracture behaviors of the as-deposited specimen and five types of heat-treated specimens were mainly investigated. The results indicate the as-deposited microstructure of LAM AerMet100 steel with a high amount of retained austenite has a high KIC value of ~ 81.7 MPa m1/2. After a short process of cryogenic treatment and subsequent tempering treatment, the KIC value of the steel has the lowest value of ~ 60 MPa m1/2 due to the apparent decrease of austenite and weak cracking resistance, associating with intergranular cracking along the prior austenite columnar grain boundaries and transgranular cracking of intercellular regions. In contrast, the crack-tip fracture mode of the equiaxed-grain tempered martensite microstructure of LAM AerMet100 steel becomes completely transgranular cracking with the main mechanisms of micro-void nucleation and coalescence. Homogenization treatment can apparently decrease the amount and size of large-size alloy carbides and effectively improve the fracture toughness of the steel. Furthermore, proper microstructure modification (including control of large-size carbide, grain refinement and a decrease of retained austenite) by a longer treatment process can prompt tempered LAM AerMet100 steel to achieve a good combination of yield strength (~ 1827 MPa) and fracture toughness (~ 113 MPa m1/2) compared with the wrought one.

Optimizing the coordination/surrounding environments of active metal nanoclusters to promote the catalytic performance during hydrogen evolution reaction (HER) in alkaline media is highly important but extremely challenging. Here, we demonstrate that novel S-coordinated ruthenium (Ru) nanoclusters anchored on N/S-codoped carbon nanosheets (Ru–S/N–C) can be successfully synthesized via the space-confinement pyrolysis of Ru complexes in the framework of polyaniline–ammonia persulfate supermolecules. X-ray absorption fine structure spectroscopy and X-ray photoelectron spectroscopy studies reveal the local coordination structure of Ru–S bonds, the surrounding N/S/C environments of Ru, and the synergistic electronic interactions among N, S, C and Ru atoms. Theoretical calculations further confirm that the coordination/surrounding environments could optimize the adsorption energies of intermediates on Ru through interfacial charge transfer and, thus, accelerate the reaction kinetics of hydrogen evolution. The fabricated Ru–S/N–C exhibits an ultra-small overpotential of 10 mV at 10 mA cm−2 and an extremely high turnover frequency (TOF) of 2.3 H2 s−1 at an overpotential of 50 mV for the HER, as well as a mass catalytic activity about 10 times higher than that of a commercial Pt/C catalyst.

BackgroundObstructive sleep apnea (OSA) and atrial fibrillation (AF) are epidemiologically correlated, but the causal relationship between them remains elusive. We aimed to explore the causal relationships between OSA and AF.MethodUsing both the Finnish biobank and publicly available genome-wide association study data (GWAS), we conducted a two-sample Mendelian randomization (MR) analysis to estimate the causal effect of OSA on AF, both in the primary analysis and replicated analysis. The inverse variance weighted MR was selected as the main method. To further test the independent causal effect of OSA on AF, we also performed multivariable MR (MVMR), adjusting for body mass index (BMI), hypertension, and coronary artery disease (CAD), respectively.ResultsIn the primary analysis, OSA was significantly associated with the increased risk of AF (OR 1.21, 95% CI 1.11–1.32) and the replicated analysis showed consistent results (OR 1.17, 95% CI 1.05–1.30). Besides, there was no heterogeneity and horizontal pleiotropy observed both in the primary and replicated analysis. Further multivariable MR suggested that the causal relationships between OSA and AF exist independently of BMI and CAD. The MVMR result after the adjustment for hypertension is similar in magnitude and direction to the univariable MR. But it did not support a causal relationship between OSA and AF.ConclusionOur study found that genetically driven OSA causally promotes AF. This causal relationship sheds new light on taking effective measures to prevent and treat OSA to reduce the risk of AF.

Background: Observational studies have revealed the association between some inflammatory cytokines and the occurrence of ischemic stroke, but the causal relationships remain unclear.Methods: We conducted a two-sample Mendelian randomization (MR) analysis to assess the causal effects of thirty inflammatory cytokines and the risk of ischemic stroke. For exposure data, we collected genetic variants associated with inflammatory cytokines as instrumental variables (IVs) from a genome-wide association study (GWAS) meta-analysis from Finland (sample size up to 8,293). For the outcome data, we collected summary data of ischemic stroke from a large-scale GWAS meta-analysis involved 17 studies (34,217 cases and 406,111 controls). We further performed a series of sensitivity analyses as validation of primary MR results.Results: According to the primary MR estimations and further sensitivity analyses, we established one robust association after Bonferroni correction: the odds ratio (95% CI) per unit change in genetically increased IL-4 was 0.84 (0.89–0.95) for ischemic stroke. The chemokine MCP3 showed a nominally significant association with ischemic stroke risk (OR: 0.93, 95% CI: 0.88–0.99, unadjusted p < 0.05). There was no evidence of a causal effect of other inflammatory cytokines and the risk of ischemic stroke.Conclusions: Our study suggested that genetically increased IL-4 levels showed a protective effect on the risk of ischemic stroke, which provides important new insights into the potential therapeutic target for preventing ischemic stroke.

The primary understanding of laser-induced non-isothermal prior β grain growth behaviour of titanium alloys is given by adopting laser quenching on pure titanium. Results indicate that the prior β ...

In our previous research, titanium-based nitride with high conductivity and superior corrosion resistance were developed as an ideal core material for replacing noble metal to form Pt-based core-shell catalysts by pulse electrodeposition. Meanwhile, the smaller sizes of nitride cores would also be available for pulse electrodeposition by dispersing them on carbon nanotubes (CNT). To achieve a better practice on the preparation of the Pt-based core-shell catalysts, in this work, both nitrogen-doped carbon nanotubes (N-CNT) and reduced graphene oxide (N-rGO) were used to support the copper-doped titanium nitride (Ti0.9Cu0.1N) cores. In the course of pulse electrodeposition, their influences as supports on the electronic states of electrodeposited Pt as well as their catalytic activities were compared. The results showed that the Pt preferred to electrodeposit on Ti0.9Cu0.1N cores supported by N-CNT and formed a core-shell structure. While with the same electrodeposition process, the Pt was found to be electrodeposited not only on the Ti0.9Cu0.1N cores supported by N-rGO with heavy aggregations but also on the N-rGO support. Raman spectroscopy analysis indicated that the higher degree of structural defects on N-rGO, as support, might have contributed to such divergence observation.

Exploring advanced electrocatalysts for the sluggish oxygen reduction reaction is extremely important for fuel cell commercialization but still remains a great challenge, especially the durability issue that gains increasing attention. Herein, we demonstrate an extremely durable catalyst prototype that combines structurally ordered intermetallic nanoparticles (NPs) with mesoporous carbon. With ZIF-8 derived mesoporous carbon supported Pt3Co intermetallic NPs (Pt3Co/DMC-F) as an example, we illustrate its synthetic details, electrocatalytic performance and durability enhancement mechanism. The Pt3Co/DMC-F catalyst exhibited significant enhancement in activity and durability. More importantly, its extraordinary performance was observed/verified in a H2/air PEM single cell test. The confinement of mesoporous carbon not only efficiently controls the particle size of Pt3Co and hampers their aggregation during thermal annealing and electrochemical reactions, but also significantly suppresses detachment. Beyond offering an advanced electrocatalyst, this study provides a solution to the durability issue of cathodes that has prevented practical application of proton exchange membrane fuel cells.

Given the considerable scale of distribution networks in urban and rural areas, as well as the lack of management records, adjustments of switches during the distribution system operation are poorly documented. Such deficiency results in the inaccuracy of models stored in the distribution network automation system, and thus misleads the state estimation. With the emergence of information and communication technology, a large number of the feeder and residential smart meter data are accumulated. Such data can help recognize the operation modes of distribution networks by analyzing the relationships between the on/off states of switches and the voltage correlations among buses. However, the limited quantity and quality of the sampling data restrict the implementation of data-driven recognition. In this paper, a physical-probabilistic-network (PPN) model applied for inferring overall operation mode of distribution networks is proposed. Based on which, a belief propagation-based algorithm is proposed for the inference even under situations when there are only partial bus voltages data available. Meanwhile, the required variable for inference can be reduced from the active trail analysis. Experiment results are used to compare its performance with classic methods and to prove its effectiveness and advantages.

Background: Insulin resistance (IR) is closely associated with the pathogenesis of type 2 diabetes mellitus (T2DM). However, remission of insulin sensitivity after bariatric surgery in patients with T2DM and a body mass index (BMI) of 27.5–32.5 kg/m2 has not been fully elucidated.Methods: Thirty-six T2DM patients with a BMI of 27.5–32.5 kg/m2 were prospectively consecutively recruited for laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). Hyperinsulinemic euglycemic clamp, oral glucose tolerance test (OGTT), and other indicators were tested at baseline and 6 months postoperative. Glucose disposal rate (GDR), time to reach euglycemia, homeostatic model assessment of IR, quantitative insulin sensitivity check index (QUICKI), triglyceride glucose (TyG) index, 30-min insulinogenic index (IGI30), and disposition index (DI) were calculated at baseline and 6 months after surgery. The criterion for remission in T2DM patients was the achievement of the triple composite endpoint.Results: Anthropometric and glucolipid metabolism parameters significantly improved following surgery. The GDR increased significantly from baseline to 6 months after LRYGB (from 4.28 ± 1.70 mg/kg/min to 8.47 ± 1.89 mg/kg/min, p < 0.0001) and LSG (from 3.18 ± 1.36 mg/kg/min to 7.09 ± 1.69 mg/kg/min, p < 0.001). The TyG index decreased after surgery (RYGB group, from 9.93 ± 1.03 to 8.60 ± 0.43, p < 0.0001; LSG group, from 10.04 ± 0.79 to 8.72 ± 0.65, p = 0.0002). There was a significant reduction in the IGI30 (RYGB group, from 2.04 ± 2.12 to 0.83 ± 0.47, p = 0.005; LSG group, from 2.12 ± 1.73 to 0.92 ± 0.66, p = 0.001). The mean DI significantly increased from 1.14 ± 1.35 to 7.11 ± 4.93 in the RYGB group (p = 0.0001) and from 1.25 ± 1.78 to 5.60 ± 4.58 in the LSG group (p = 0.003). Compared with baseline, HOMR-IR, QUICKI, area under the curve-C-peptide release test (AUC-CRT), and AUC-OGTT were significantly changed at 6 months postoperative. Overall, 52.63% of patients in the LRYGB group versus 29.41% of patients in the LSG group achieved the triple composite endpoint.Conclusion: Both LRYGB and LSG effectively induced remission of IR in patients with T2DM and a BMI of 27.5–32.5 kg/m2.

Background: Insulin resistance (IR) is closely associated with the pathogenesis of type 2 diabetes mellitus (T2DM). However, remission of insulin sensitivity after bariatric surgery in patients with T2DM and a body mass index (BMI) of 27.5–32.5 kg/m2 has not been fully elucidated. Methods: Thirty-six T2DM patients with a BMI of 27.5–32.5 kg/m2 were prospectively consecutively recruited for laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). Hyperinsulinemic euglycemic clamp, oral glucose tolerance test (OGTT), and other indicators were tested at baseline and 6 months postoperative. Glucose disposal rate (GDR), time to reach euglycemia, homeostatic model assessment of IR, quantitative insulin sensitivity check index (QUICKI), triglyceride glucose (TyG) index, 30-min insulinogenic index (IGI30), and disposition index (DI) were calculated at baseline and 6 months after surgery. The criterion for remission in T2DM patients was the achievement of the triple composite endpoint. Results: Anthropometric and glucolipid metabolism parameters significantly improved following surgery. The GDR increased significantly from baseline to 6 months after LRYGB (from 4.28 ± 1.70 mg/kg/min to 8.47 ± 1.89 mg/kg/min, p < 0.0001) and LSG (from 3.18 ± 1.36 mg/kg/min to 7.09 ± 1.69 mg/kg/min, p < 0.001). The TyG index decreased after surgery (RYGB group, from 9.93 ± 1.03 to 8.60 ± 0.43, p < 0.0001; LSG group, from 10.04 ± 0.79 to 8.72 ± 0.65, p = 0.0002). There was a significant reduction in the IGI30 (RYGB group, from 2.04 ± 2.12 to 0.83 ± 0.47, p = 0.005; LSG group, from 2.12 ± 1.73 to 0.92 ± 0.66, p = 0.001). The mean DI significantly increased from 1.14 ± 1.35 to 7.11 ± 4.93 in the RYGB group (p = 0.0001) and from 1.25 ± 1.78 to 5.60 ± 4.58 in the LSG group (p = 0.003). Compared with baseline, HOMR-IR, QUICKI, area under the curve-C-peptide release test (AUC-CRT), and AUC-OGTT were significantly changed at 6 months postoperative. Overall, 52.63% of patients in the LRYGB group versus 29.41% of patients in the LSG group achieved the triple composite endpoint. Conclusion: Both LRYGB and LSG effectively induced remission of IR in patients with T2DM and a BMI of 27.5–32.5 kg/m2.