Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide secretion are associated with Roux-en-Y gastric bypass but not adjustable gastric banding

被引:294
作者
Korner, Judith [1 ]
Bessler, Marc [2 ]
Inabnet, William [2 ]
Taveras, Carmen [1 ]
Holst, Jens Juul [3 ]
机构
[1] Columbia Univ Coll Phys & Surg, Dept Med, New York, NY 10032 USA
[2] Columbia Univ Coll Phys & Surg, Dept Surg, New York, NY 10032 USA
[3] Univ Copenhagen, Panum Inst, Dept Med Physiol, DK-2200 Copenhagen N, Denmark
关键词
Gastric bypass; Gastric banding; Glucagon-like peptide-1; GLP-1; Glucose-dependent insulinotropic peptide; GIP; Glucagon; Incretins; Bariatric surgery; Hyperinsulinemia; Glucose homeostasis; Obesity;
D O I
10.1016/j.soard.2007.08.004
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The aim of this study was to measure the circulating levels of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and glucagon in patients who had undergone adjustable gastric banding (BND) or Roux-en-Y gastric bypass (RYGB) to understand the differences in glucose and insulin regulation after these procedures. Methods: This was a cross-sectional study of 3 groups of women matched for age and body mass index: group 1, overweight controls (n = 13); group 2, BND (n = 10); and group 3, RYGB (n = 13). Venous blood was drawn with the patient in the fasted state and throughout a 3-hour period after a liquid meal. Results: The fasting glucose level was similar between the 2 surgery groups; however, the fasting insulin concentrations were greater in the BND (10.0 mu U/mL) than in the RYGB (6.2 mu U/mL; P<0.05) group. The glucose level at 60 minutes was significantly lower in the RYGB group (70 mg/dL, range 38-82) than in the BND group (83 mg/dL, range 63-98). The GLP-1 levels at 30 minutes were more than threefold greater in the RYGB group (96 pmol/L compared with the BND and overweight control (28 pmol/L) groups. The GLP-1 and insulin concentrations correlated at 30 minutes only in the RYGB group (r =.66; P =.013). The glucose-dependent insulinotropic peptide levels at 30 minutes were lower in the RYGB group (20 pmol/L) than in the BND group (31 pmol/L) or overweight control group (33 pmol/L). The peak glucagon levels were similar among the 3 groups. Conclusion: Exaggerated postprandial GLP-1 and blunted glucose-dependent insulinotropic peptide secretion after RYGB might contribute to the greater weight loss and improved glucose homeostasis compared with BND. (Surg Obes Relat Dis 2007;3:597-601.) (C) 2007 American Society for Metabolic and Bariatric Surgery. All rights reserved.
引用
收藏
页码:597 / 601
页数:5
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