Type 2 diabetes mellitus remission in sleeve gastrectomy patients: Role of enteroendocrine response and serum citrulline and I-FABP levels.

Background: This prospective cohort study examines the relationship between post-sleeve gastrectomy (SG) weight loss and serum citrulline, I-FABP levels, and the I-FABP/citrulline ratio in obese patients, alongside the correlation with type 2 diabetes mellitus (T2DM) remission.

Methods: 88 participants were enrolled, including 48 undergoing SG and 21 with T2DM. 40 healthy individuals served as controls. Preoperative and 1-year postoperative assessments included citrulline, I-FABP, glucose, insulin, HbA1c, and C peptide levels.

Results: Significant weight loss and T2DM remission (11/21) were observed post-SG. Preoperatively, patients had low citrulline and high I-FABP levels, which normalized postoperatively. A positive correlation was found between the I-FABP/citrulline ratio and weight, BMI, glucose, insulin, and C peptide levels.

Conclusions: SG not only induces enterocyte dysfunction and mass recovery but also may facilitate T2DM remission and alleviate obesity-related effects on the enteroendocrine system. These findings highlight the potential beneficial effects of SG on enteroendocrine function in obese patients.