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Long-term effects of Roux-en-Y gastric bypass surgery on plasma glucagon-like peptide-1 and islet function in morbidly obese subjects.
J Clin Endocrinol Metab. 2009 Mar; 94(3):884-91.JC

Abstract

CONTEXT

An enlarged incretin response after Roux-en-Y gastric bypass (RYGBP) has been proposed to promote excessive beta-cell function and mass.

OBJECTIVE

The objective of the study was to determine whether RYGBP is associated with a steadily increased glucagon-like peptide 1 (GLP-1) response and a disruption of the relationship between insulin sensitivity and insulin secretion required to maintain plasma glucose in the normal range.

DESIGN AND PATIENTS

This was a cross-sectional study. Twenty-four women divided into three groups according to time after RYGBP (9-15, 21-30, and more than 36 months). Eight normal-weight and eight morbidly obese women served as controls.

MAIN OUTCOME MEASURES

GLP-1 was determined after a standardized test meal. Insulin secretion (AIRg) and insulin sensitivity (S(I)) were derived from an iv glucose tolerance test. Postprandial glucose profile was recorded with a continuous glucose monitoring system.

RESULTS

Area under the curve(0-120) of GLP-1 was larger after RYGBP compared with controls (P < 0.01) but was comparable among surgical groups (P =0.314). Time after surgery was not associated with changes in S(I) (P = 0.657), AIRg (P = 0.329), or the disposition index (DI = AIRgS(I), P = 0.915). After surgery, the GLP-1 response and the DI were not significantly correlated (P = 0.304). Glucose less than 50 mg/dl was found in operated subjects, but the proportion did not increase with time after surgery (P = 0.459). Neither the GLP-1 response (P = 0.620) nor the DI (P = 0.457) differed significantly between those with or without hypoglycemic episodes.

CONCLUSIONS

Although the GLP-1 response to meal intake is steadily elevated after RYGBP, this does not result over time in the development of an inappropriate insulin secretion relative to the prevailing insulin sensitivity or the occurrence of hypoglycemic episodes.

Authors+Show Affiliations

Obesity Unit, Endocrinology and Diabetes Department, Hospital Clínic Universitari, Villarroel 170, 08036 Barcelona, Spain. jovidal@clinic.ub.esNo affiliation info availableNo affiliation info availableNo 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

19106269

Citation

Vidal, Josep, et al. "Long-term Effects of Roux-en-Y Gastric Bypass Surgery On Plasma Glucagon-like Peptide-1 and Islet Function in Morbidly Obese Subjects." The Journal of Clinical Endocrinology and Metabolism, vol. 94, no. 3, 2009, pp. 884-91.
Vidal J, Nicolau J, Romero F, et al. Long-term effects of Roux-en-Y gastric bypass surgery on plasma glucagon-like peptide-1 and islet function in morbidly obese subjects. J Clin Endocrinol Metab. 2009;94(3):884-91.
Vidal, J., Nicolau, J., Romero, F., Casamitjana, R., Momblan, D., Conget, I., Morínigo, R., & Lacy, A. M. (2009). Long-term effects of Roux-en-Y gastric bypass surgery on plasma glucagon-like peptide-1 and islet function in morbidly obese subjects. The Journal of Clinical Endocrinology and Metabolism, 94(3), 884-91. https://doi.org/10.1210/jc.2008-1620
Vidal J, et al. Long-term Effects of Roux-en-Y Gastric Bypass Surgery On Plasma Glucagon-like Peptide-1 and Islet Function in Morbidly Obese Subjects. J Clin Endocrinol Metab. 2009;94(3):884-91. PubMed PMID: 19106269.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term effects of Roux-en-Y gastric bypass surgery on plasma glucagon-like peptide-1 and islet function in morbidly obese subjects. AU - Vidal,Josep, AU - Nicolau,Joana, AU - Romero,Fabiola, AU - Casamitjana,Roser, AU - Momblan,Dulce, AU - Conget,Ignacio, AU - Morínigo,Rosa, AU - Lacy,Antonio M, Y1 - 2008/12/23/ PY - 2008/12/25/entrez PY - 2008/12/25/pubmed PY - 2009/4/8/medline SP - 884 EP - 91 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 94 IS - 3 N2 - CONTEXT: An enlarged incretin response after Roux-en-Y gastric bypass (RYGBP) has been proposed to promote excessive beta-cell function and mass. OBJECTIVE: The objective of the study was to determine whether RYGBP is associated with a steadily increased glucagon-like peptide 1 (GLP-1) response and a disruption of the relationship between insulin sensitivity and insulin secretion required to maintain plasma glucose in the normal range. DESIGN AND PATIENTS: This was a cross-sectional study. Twenty-four women divided into three groups according to time after RYGBP (9-15, 21-30, and more than 36 months). Eight normal-weight and eight morbidly obese women served as controls. MAIN OUTCOME MEASURES: GLP-1 was determined after a standardized test meal. Insulin secretion (AIRg) and insulin sensitivity (S(I)) were derived from an iv glucose tolerance test. Postprandial glucose profile was recorded with a continuous glucose monitoring system. RESULTS: Area under the curve(0-120) of GLP-1 was larger after RYGBP compared with controls (P < 0.01) but was comparable among surgical groups (P =0.314). Time after surgery was not associated with changes in S(I) (P = 0.657), AIRg (P = 0.329), or the disposition index (DI = AIRgS(I), P = 0.915). After surgery, the GLP-1 response and the DI were not significantly correlated (P = 0.304). Glucose less than 50 mg/dl was found in operated subjects, but the proportion did not increase with time after surgery (P = 0.459). Neither the GLP-1 response (P = 0.620) nor the DI (P = 0.457) differed significantly between those with or without hypoglycemic episodes. CONCLUSIONS: Although the GLP-1 response to meal intake is steadily elevated after RYGBP, this does not result over time in the development of an inappropriate insulin secretion relative to the prevailing insulin sensitivity or the occurrence of hypoglycemic episodes. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/19106269/Long_term_effects_of_Roux_en_Y_gastric_bypass_surgery_on_plasma_glucagon_like_peptide_1_and_islet_function_in_morbidly_obese_subjects_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2008-1620 DB - PRIME DP - Unbound Medicine ER -