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We related the histology of subcutaneous (SAT), visceral fat (VAT), and skeletal muscle to the metabolic abnormalities, and tested their mutual changes after bariatric surgery in type 2 diabetic (T2D) and weight-matched non-diabetic (ND) patients. We measured IR (insulin clamp), lipolysis (<jats:sup>2<\/jats:sup>H<jats:sub>5<\/jats:sub>-glycerol infusion), \u00df-cell glucose-sensitivity (\u00df-GS, mathematical modeling), and VAT, SAT, and <jats:italic>rectus abdominis<\/jats:italic> histology (light and electron microscopy). Presurgery, SAT and VAT showed signs of fibrosis\/necrosis, small mitochondria, free interstitial lipids, thickened capillary basement membrane. Compared to ND, T2D had impaired \u00df-GS, intracapillary neutrophils and higher intramyocellular fat, adipocyte area in VAT, crown-like structures (CLS) in VAT and SAT with rare structures (cyst-like) ~10-fold larger than CLS. Fat expansion was associated with enhanced lipolysis and IR. VAT histology and intramyocellular fat were related to impaired \u00df-GS. Postsurgery, IR and lipolysis improved in all, \u00df-GS improved in T2D. Muscle fat infiltration was reduced, adipocytes were smaller and richer in mitochondria, and CLS density in SAT was reduced. In conclusion, IR improves proportionally to weight loss but remains subnormal, whilst SAT and muscle changes disappear. In T2D postsurgery, some VAT pathology persists and beta-cell dysfunction improves but is not normalized.<\/jats:p>","DOI":"10.1038\/s41598-017-08444-6","type":"journal-article","created":{"date-parts":[[2017,8,15]],"date-time":"2017-08-15T15:20:04Z","timestamp":1502810404000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["Muscle and adipose tissue morphology, insulin sensitivity and beta-cell function in diabetic and nondiabetic obese patients: effects of bariatric surgery"],"prefix":"10.1038","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9015-7244","authenticated-orcid":false,"given":"Stefania","family":"Camastra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Vitali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Anselmino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2594-1651","authenticated-orcid":false,"given":"Amalia","family":"Gastaldelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Bellini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Berta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3985-1131","authenticated-orcid":false,"given":"Ilenia","family":"Severi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Baldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenno","family":"Astiarraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Barbatelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"Cinti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ele","family":"Ferrannini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,8,21]]},"reference":[{"key":"8444_CR1","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1038\/nature05485","volume":"444","author":"GS Hotamisligil","year":"2006","unstructured":"Hotamisligil, G. 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The error has not been fixed in the paper.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A.G. has served as a consultant for Roche, Eli-Lilly, Menarini, Inventiva and has received Research Support from Amylin-BMS-AZ; E.F. has served as an ad hoc consultant and occasional speaker for Boehringer Ingelheim, Merck & Co., Sanofi, Lilly & Co., Johnson & Johnson, AstraZeneca, and Novo Nordisk, and has received research grants from Lilly & Co. and Boehringer Ingelheim. No other potential conflicts of interest relevant to this article are reported.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"9007"}}