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Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus.
Am Surg. 2004 Jan; 70(1):1-4; discussion 4-5.AS

Abstract

Morbid obesity (MO) is associated with diabetes mellitus-type II (DM-II). Roux-en Y gastric bypass (RNY) has been shown to normalize glucose intolerance in these patients through an incompletely understood mechanism. Gastrointestinal hormonal changes have been suggested as an explanation for resolution of DM II. Preoperatively, 20 MO patients with DM-II were evaluated for demographics and fasting levels of the following: glucose, insulin, C-peptide, glucagon, cortisol, gastric inhibitory polypeptide (GIP), and glucagon-like peptide-1 (GLP-1). Each patient underwent RNY with a 15-cc gastric pouch and 150-cm Roux limb. Postoperatively, each of the variables was measured at 2 weeks, 6 weeks, and 12 weeks and compared with the preoperative result using Student t test with significance, P = 0.05. Results are expressed as mean +/- SD. Twenty patients (5 male and 15 female), age 40.3 +/- 7.9 years, weight 146.3 +/- 34.0 kg, height 158.7 +/- 18.7 cm, and BMI 52.7 +/- 8.8, were enrolled in this IRB-approved protocol. Weight and BMI decreased progressively (117.5 +/- 26.9 kg and 47.0 +/- 7.4, P = 0.01, respectively) during the study but reached significance only at 12 weeks. Fasting plasma glucose decreased significantly within 2 weeks after RNY. Insulin and cortisol both approached, but never achieved, significant changes over 12 weeks. GLP-1 increased initially, but not significantly. GIP and C-peptide both decreased significantly. Glucagon remained essentially unchanged over 12 weeks. RNY rapidly normalizes fasting plasma glucose in morbidly obese patients with DM-II. GIP, a gactor in the enteroinsulin axis, decreases and may play a role in the correction of DM-II after gastric bypass.

Authors+Show Affiliations

Department of Surgery, Section of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14964537

Citation

Clements, Ronald H., et al. "Hormonal Changes After Roux-en Y Gastric Bypass for Morbid Obesity and the Control of type-II Diabetes Mellitus." The American Surgeon, vol. 70, no. 1, 2004, pp. 1-4; discussion 4-5.
Clements RH, Gonzalez QH, Long CI, et al. Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus. Am Surg. 2004;70(1):1-4; discussion 4-5.
Clements, R. H., Gonzalez, Q. H., Long, C. I., Wittert, G., & Laws, H. L. (2004). Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus. The American Surgeon, 70(1), 1-4; discussion 4-5.
Clements RH, et al. Hormonal Changes After Roux-en Y Gastric Bypass for Morbid Obesity and the Control of type-II Diabetes Mellitus. Am Surg. 2004;70(1):1-4; discussion 4-5. PubMed PMID: 14964537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hormonal changes after Roux-en Y gastric bypass for morbid obesity and the control of type-II diabetes mellitus. AU - Clements,Ronald H, AU - Gonzalez,Quintin H, AU - Long,Calvin I, AU - Wittert,Gary, AU - Laws,Henry L, PY - 2004/2/18/pubmed PY - 2004/3/16/medline PY - 2004/2/18/entrez SP - 1-4; discussion 4-5 JF - The American surgeon JO - Am Surg VL - 70 IS - 1 N2 - Morbid obesity (MO) is associated with diabetes mellitus-type II (DM-II). Roux-en Y gastric bypass (RNY) has been shown to normalize glucose intolerance in these patients through an incompletely understood mechanism. Gastrointestinal hormonal changes have been suggested as an explanation for resolution of DM II. Preoperatively, 20 MO patients with DM-II were evaluated for demographics and fasting levels of the following: glucose, insulin, C-peptide, glucagon, cortisol, gastric inhibitory polypeptide (GIP), and glucagon-like peptide-1 (GLP-1). Each patient underwent RNY with a 15-cc gastric pouch and 150-cm Roux limb. Postoperatively, each of the variables was measured at 2 weeks, 6 weeks, and 12 weeks and compared with the preoperative result using Student t test with significance, P = 0.05. Results are expressed as mean +/- SD. Twenty patients (5 male and 15 female), age 40.3 +/- 7.9 years, weight 146.3 +/- 34.0 kg, height 158.7 +/- 18.7 cm, and BMI 52.7 +/- 8.8, were enrolled in this IRB-approved protocol. Weight and BMI decreased progressively (117.5 +/- 26.9 kg and 47.0 +/- 7.4, P = 0.01, respectively) during the study but reached significance only at 12 weeks. Fasting plasma glucose decreased significantly within 2 weeks after RNY. Insulin and cortisol both approached, but never achieved, significant changes over 12 weeks. GLP-1 increased initially, but not significantly. GIP and C-peptide both decreased significantly. Glucagon remained essentially unchanged over 12 weeks. RNY rapidly normalizes fasting plasma glucose in morbidly obese patients with DM-II. GIP, a gactor in the enteroinsulin axis, decreases and may play a role in the correction of DM-II after gastric bypass. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/14964537/Hormonal_changes_after_Roux_en_Y_gastric_bypass_for_morbid_obesity_and_the_control_of_type_II_diabetes_mellitus_ L2 - https://ClinicalTrials.gov/search/term=14964537 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -