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Changes in glucose homeostasis after Roux-en-Y gastric bypass surgery for obesity at day three, two months, and one year after surgery: role of gut peptides.
J Clin Endocrinol Metab. 2011 Jul; 96(7):2227-35.JC

Abstract

CONTEXT

Endocrine effects of gastric bypass (GBP) surgery for obesity on glucose homeostasis are not fully understood.

MAIN OBJECTIVE

The main objective of the study was to assess the changes in plasma glucose, insulin, glucagon-like peptide-1 (GLP-1), leptin, somatostatin, glucose-dependent insulinotropic peptide, enteroglucagon, and glucagon early after GBP.

METHOD

Twelve obese subjects (body mass index 45.3 ± 1.9 kg/m(2)) were subjected to a liquid meal without lipids before and 3 d, 2 months, and 1 yr after GBP. Plasma concentrations of glucose, insulin, leptin, and gut peptide hormones were assessed before and for 180 min after the meal. Satiety was measured with visual analog scales. The absorption rate of acetaminophen added to the liquid meal was measured. Insulin resistance was measured by the homeostasis model assessment of insulin resistance.

RESULTS

All subjects lost weight (body mass index 30.3 ± 1.8 kg/m(2) at 1 yr). Fasting glucose was significantly lower on d 3 (P < 0.05). There was a progressive decrease in the homeostasis model assessment of insulin resistance after 2 months postoperatively. Postprandially, there was a progressive rise of GLP-1 and enteroglucagon and a transient increase in pancreatic glucagon release over the study period. There was a leftward shift of the time course of plasma glucose and insulin. Somatostatin release was lower on d 3 (P < 0.05) but then unchanged. The absorption rate of acetaminophen was twice as fast after GBP compared with before surgery and did not change over time. Satiety scores increased markedly postoperatively.

CONCLUSION

Both enhanced insulin sensitivity and incretin hormones, such as GLP-1, contribute to the early control of glucose homeostasis. Progressively increasing postprandial levels of enteroglucagon (oxyntomodulin) and GLP-1 facilitate weight loss and enhance insulin effectiveness.

Authors+Show Affiliations

Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, SE-182 88 Stockholm, Sweden. ylva.falken@ds.seNo 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

21543426

Citation

Falkén, Y, et al. "Changes in Glucose Homeostasis After Roux-en-Y Gastric Bypass Surgery for Obesity at Day Three, Two Months, and One Year After Surgery: Role of Gut Peptides." The Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 7, 2011, pp. 2227-35.
Falkén Y, Hellström PM, Holst JJ, et al. Changes in glucose homeostasis after Roux-en-Y gastric bypass surgery for obesity at day three, two months, and one year after surgery: role of gut peptides. J Clin Endocrinol Metab. 2011;96(7):2227-35.
Falkén, Y., Hellström, P. M., Holst, J. J., & Näslund, E. (2011). Changes in glucose homeostasis after Roux-en-Y gastric bypass surgery for obesity at day three, two months, and one year after surgery: role of gut peptides. The Journal of Clinical Endocrinology and Metabolism, 96(7), 2227-35. https://doi.org/10.1210/jc.2010-2876
Falkén Y, et al. Changes in Glucose Homeostasis After Roux-en-Y Gastric Bypass Surgery for Obesity at Day Three, Two Months, and One Year After Surgery: Role of Gut Peptides. J Clin Endocrinol Metab. 2011;96(7):2227-35. PubMed PMID: 21543426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in glucose homeostasis after Roux-en-Y gastric bypass surgery for obesity at day three, two months, and one year after surgery: role of gut peptides. AU - Falkén,Y, AU - Hellström,P M, AU - Holst,J J, AU - Näslund,E, Y1 - 2011/05/04/ PY - 2011/5/6/entrez PY - 2011/5/6/pubmed PY - 2011/9/13/medline SP - 2227 EP - 35 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 96 IS - 7 N2 - CONTEXT: Endocrine effects of gastric bypass (GBP) surgery for obesity on glucose homeostasis are not fully understood. MAIN OBJECTIVE: The main objective of the study was to assess the changes in plasma glucose, insulin, glucagon-like peptide-1 (GLP-1), leptin, somatostatin, glucose-dependent insulinotropic peptide, enteroglucagon, and glucagon early after GBP. METHOD: Twelve obese subjects (body mass index 45.3 ± 1.9 kg/m(2)) were subjected to a liquid meal without lipids before and 3 d, 2 months, and 1 yr after GBP. Plasma concentrations of glucose, insulin, leptin, and gut peptide hormones were assessed before and for 180 min after the meal. Satiety was measured with visual analog scales. The absorption rate of acetaminophen added to the liquid meal was measured. Insulin resistance was measured by the homeostasis model assessment of insulin resistance. RESULTS: All subjects lost weight (body mass index 30.3 ± 1.8 kg/m(2) at 1 yr). Fasting glucose was significantly lower on d 3 (P < 0.05). There was a progressive decrease in the homeostasis model assessment of insulin resistance after 2 months postoperatively. Postprandially, there was a progressive rise of GLP-1 and enteroglucagon and a transient increase in pancreatic glucagon release over the study period. There was a leftward shift of the time course of plasma glucose and insulin. Somatostatin release was lower on d 3 (P < 0.05) but then unchanged. The absorption rate of acetaminophen was twice as fast after GBP compared with before surgery and did not change over time. Satiety scores increased markedly postoperatively. CONCLUSION: Both enhanced insulin sensitivity and incretin hormones, such as GLP-1, contribute to the early control of glucose homeostasis. Progressively increasing postprandial levels of enteroglucagon (oxyntomodulin) and GLP-1 facilitate weight loss and enhance insulin effectiveness. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/21543426/Changes_in_glucose_homeostasis_after_Roux_en_Y_gastric_bypass_surgery_for_obesity_at_day_three_two_months_and_one_year_after_surgery:_role_of_gut_peptides_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2010-2876 DB - PRIME DP - Unbound Medicine ER -