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Molecular mechanisms involved in the extracellular matrix remodeling of skeletal muscle of obese patients undergoing bariatric surgery: role of insulin resistance and effects of exercise training

Grant number: 17/01427-9
Support Opportunities:Scholarships abroad - Research Internship - Doctorate
Effective date (Start): January 05, 2018
Effective date (End): January 04, 2019
Field of knowledge:Health Sciences - Physical Education
Principal Investigator:Bruno Gualano
Grantee:Wagner Silva Dantas
Supervisor: John Patrick Kirwan
Host Institution: Escola de Educação Física e Esporte (EEFE). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Research place: Cleveland Clinic Foundation, United States  
Associated to the scholarship:15/02835-8 - Effects of exercise training on insulin resistance and lipid oxidation in skeletal muscle in patients undergoing bariatric surgery: a randomized trial, BP.DR


Nowadays, bariatric surgery is considered one of the main treatments for obesity once drug treatment associated with lifestyle changes is ineffective in promote a significant body weight reduction. Reducing of body weight (through bariatric surgery or not) and exercise training are important treatment options for the clinical management of obesity. The rationality that the vascular environment may be an important contributory factor to insulin resistance action in skeletal muscle arose from studies with the obese Indians Pima where it was demonstrated that insulin resistance was inversely associated with capillary density in the skeletal muscle of this population. In fact, the reduction of capillary density in the skeletal muscle (known as microvascular rarefaction) in obese patients is associated with decreased sensitivity to insulin action in the same territory and appears to be directly proportional to the increase in adiposity.The discussion remains about their respective effects on insulin resistance and capillary rarefaction on skeletal muscle. On the topic of bariatric surgery, recent studies have shown a slight improvement in insulin sensitivity in skeletal muscle in non-diabetic obese patients, despite a pronounced reduction in body weight in these patients. To date, no study has evaluated the relationship between insulin resistance and microvascular rarefaction in the skeletal muscle of obese patients undergoing bariatric surgery. Exercise training has shown encouraging results with regard to increased capillarization in skeletal muscle in lean individuals and insulin resistance patients. However, there is no evidence about the role of exercise training in improving insulin resistance in patients undergoing bariatric surgery, as well as the relationship with microvascular rarefaction in the skeletal muscle of this population. Therefore, the understanding of the physiological, molecular and clinical responses to exercise training in patients undergoing bariatric surgery can be considered as of vital importance for the development of therapeutic strategies (drugs or exercise) dedicated to the treatment of insulin resistance present in this disease. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DANTAS, WAGNER S.; ROSCHEL, HAMILTON; MURAI, IGOR H.; GIL, SAULO; DAVULURI, GANGARAO; AXELROD, CHRISTOPHER L.; GHOSH, SUJOY; NEWMAN, SUSAN S.; ZHANG, HUI; SHINJO, SAMUEL K.; et al. Exercise-Induced Increases in Insulin Sensitivity After Bariatric Surgery Are Mediated By Muscle Extracellular Matrix Remodeling. Diabetes, v. 69, n. 8, p. 1675-1691, . (15/02835-8, 16/10993-5, 17/01427-9)
DANTAS, WAGNER SILVA; GIL, SAULO; MURAI, IGOR HISASHI; COSTA-HONG, VALERIA; PECANHA, TIAGO; ABUJABRA MEREGE-FILHO, CARLOS ALBERTO; DE SA-PINTO, ANA LUCIA; DE CLEVA, ROBERTO; SANTO, MARCO AURELIO; RODRIGUES PEREIRA, ROSA MARIA; et al. Reversal of Improved Endothelial Function After Bariatric Surgery Is Mitigated by Exercise Training. Journal of the American College of Cardiology, v. 72, n. 18, p. 2278-2279, . (15/02835-8, 17/01427-9, 16/10993-5)
MURAI, IGOR H.; ROSCHEL, HAMILTON; DANTAS, WAGNER S.; GIL, SAULO; MEREGE-FILHO, CARLOS; DE CLEVA, ROBERTO; DE SA-PINTO, ANA L.; LIMA, FERNANDA; SANTO, MARCO A.; BENATTI, FABIANA B.; et al. Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, v. 104, n. 10, p. 4639-4650, . (16/10993-5, 17/01427-9, 15/02833-5)

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