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GLP-1 and changes in glucose tolerance following gastric bypass surgery in morbidly obese subjects.
Obes Surg. 2006 Dec; 16(12):1594-601.OS

Abstract

BACKGROUND

It has been proposed, that the dramatic amelioration of type 2 diabetes following Roux-en-Y gastric bypass (RYGBP) could by accounted for, at least in part, by changes in glucagon-like peptide-1 (GLP-1) secretion. However, human data supporting this hypothesis is scarce.

METHODS

A 12-month prospective study on the changes in glucose homeostasis, and active GLP-1 in response to a standard test meal (STM) was conducted in 34 obese subjects (BMI 49.1+/-1.0 kg/m(2)) who had different degrees of glucose tolerance: normal glucose tolerance (NGT, n=12), impaired glucose tolerance (IGT, n=12), and type 2 diabetes (n=10).

RESULTS

At 6 weeks after RYGBP, despite the subjects still being markedly obese (BMI 43.5+/-0.9 kg/m(2)), fasting plasma glucose and HbA1c decreased in the 3 study groups (P<0.05). Insulin sensitivity improved, but was still abnormal in a comparable proportion of subjects among groups (P=0.717). When insulin secretion was accounted for the prevailing insulin sensitivity, an increase was found in subjects with diabetes (P<0.05) although it remained lower compared to NGT- and IGT-subjects (P<0.01). At 12 months follow-up, no differences among groups were found in the evaluated glucose homeostasis parameters. Compared to baseline, at 6 weeks the incremental AUC(0-120') of active GLP-1 in response to the STM increased in NGT and IGT (P<0.05) but not in subjects with diabetes (P=0.285). However, the GLP-1 response to a STM was comparable among groups at 12 months follow-up (P=0.887).

CONCLUSIONS

1) RYGBP was associated with an improvement but not complete restoration of glucose homeostasis at 6 weeks after surgery. 2) GLP-1 is not a critical factor for the early changes in glucose tolerance.

Authors+Show Affiliations

Obesity Unit, Hospital Clínic Universitari, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17217635

Citation

Morínigo, Rosa, et al. "GLP-1 and Changes in Glucose Tolerance Following Gastric Bypass Surgery in Morbidly Obese Subjects." Obesity Surgery, vol. 16, no. 12, 2006, pp. 1594-601.
Morínigo R, Lacy AM, Casamitjana R, et al. GLP-1 and changes in glucose tolerance following gastric bypass surgery in morbidly obese subjects. Obes Surg. 2006;16(12):1594-601.
Morínigo, R., Lacy, A. M., Casamitjana, R., Delgado, S., Gomis, R., & Vidal, J. (2006). GLP-1 and changes in glucose tolerance following gastric bypass surgery in morbidly obese subjects. Obesity Surgery, 16(12), 1594-601.
Morínigo R, et al. GLP-1 and Changes in Glucose Tolerance Following Gastric Bypass Surgery in Morbidly Obese Subjects. Obes Surg. 2006;16(12):1594-601. PubMed PMID: 17217635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - GLP-1 and changes in glucose tolerance following gastric bypass surgery in morbidly obese subjects. AU - Morínigo,Rosa, AU - Lacy,Antonio M, AU - Casamitjana,Roser, AU - Delgado,Salvadora, AU - Gomis,Ramon, AU - Vidal,Josep, PY - 2007/1/16/pubmed PY - 2007/2/16/medline PY - 2007/1/16/entrez SP - 1594 EP - 601 JF - Obesity surgery JO - Obes Surg VL - 16 IS - 12 N2 - BACKGROUND: It has been proposed, that the dramatic amelioration of type 2 diabetes following Roux-en-Y gastric bypass (RYGBP) could by accounted for, at least in part, by changes in glucagon-like peptide-1 (GLP-1) secretion. However, human data supporting this hypothesis is scarce. METHODS: A 12-month prospective study on the changes in glucose homeostasis, and active GLP-1 in response to a standard test meal (STM) was conducted in 34 obese subjects (BMI 49.1+/-1.0 kg/m(2)) who had different degrees of glucose tolerance: normal glucose tolerance (NGT, n=12), impaired glucose tolerance (IGT, n=12), and type 2 diabetes (n=10). RESULTS: At 6 weeks after RYGBP, despite the subjects still being markedly obese (BMI 43.5+/-0.9 kg/m(2)), fasting plasma glucose and HbA1c decreased in the 3 study groups (P<0.05). Insulin sensitivity improved, but was still abnormal in a comparable proportion of subjects among groups (P=0.717). When insulin secretion was accounted for the prevailing insulin sensitivity, an increase was found in subjects with diabetes (P<0.05) although it remained lower compared to NGT- and IGT-subjects (P<0.01). At 12 months follow-up, no differences among groups were found in the evaluated glucose homeostasis parameters. Compared to baseline, at 6 weeks the incremental AUC(0-120') of active GLP-1 in response to the STM increased in NGT and IGT (P<0.05) but not in subjects with diabetes (P=0.285). However, the GLP-1 response to a STM was comparable among groups at 12 months follow-up (P=0.887). CONCLUSIONS: 1) RYGBP was associated with an improvement but not complete restoration of glucose homeostasis at 6 weeks after surgery. 2) GLP-1 is not a critical factor for the early changes in glucose tolerance. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/17217635/GLP_1_and_changes_in_glucose_tolerance_following_gastric_bypass_surgery_in_morbidly_obese_subjects_ L2 - https://dx.doi.org/10.1381/096089206779319338 DB - PRIME DP - Unbound Medicine ER -