Diabetes Associated Markers After Bariatric Surgery: Fetuin-A, but Not Matrix Metalloproteinase-7, Is Reduced. 
Recent studies showed that fetuin-A and matrix metalloproteinase-7 (MMP-7) are type 2 diabetes mellitus (T2DM)-associated markers.  Bariatric surgery not only reduces body weight but also improves T2DM.  This study aimed to investigate the changes of fetuin-A and MMP-7 in obese subjects with and without T2DM after bariatric surgery.  We enrolled 130 obese subjects that received bariatric surgery, including 41 Roux-en-Y gastric bypass (RYGB), 67 mini-gastric bypass (MGB), and 22 sleeve gastrectomy (SG) patients.  Forty-three patients suffered from T2DM prior to surgery.  The fasting serum fetuin-A and MMP-7 levels were measured before and 1 year after surgery.  Only five of 43 patients remained diabetic after surgery.  Preoperative T2DM patients had higher fetuin-A and MMP-7 levels than non-T2DM subjects.  RYGB, MGB, and SG all decreased the fetuin-A levels 1 year after the operation.  The MMP-7 levels were not changed after RYGB, MGB, or SG.  In multivariate analyses, the preoperative fetuin-A was significantly related to the diastolic blood pressure (DBP) and glycosylated hemoglobin (HbA1c), while the postoperative fetuin-A was independently related to the waist-to-hip ratio and HbA1c.  Moreover, the preoperative MMP-7 level was significantly related to age, DBP, aspartate transaminase, alanine transaminase, and gamma-glutamyl transferase (rGT), while the postoperative MMP-7 level was independently related to age and rGT.  The fetuin-A and MMP-7 levels are both higher in obese T2DM than non-T2DM subjects.  The level of fetuin-A is reduced after RYGB, MGB, and SG, but the level of MMP-7 remains unchanged.