Effect of gastric bypass surgery on the incretins

被引:80
作者
Laferrere, B. [1 ]
机构
[1] Columbia Univ, Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, New York Obes Res Ctr, New York, NY 10025 USA
关键词
GLP-1; GIP; Incretin effect; Diabetes; Gastric bypass; Review; GLUCAGON-LIKE PEPTIDE-1; DUODENAL-JEJUNAL EXCLUSION; HYPERINSULINEMIC HYPOGLYCEMIA; INHIBITORY POLYPEPTIDE; ILEAL TRANSPOSITION; JEJUNOILEAL BYPASS; GLUCOSE-METABOLISM; WEIGHT-LOSS; INSULIN; GLP-1;
D O I
10.1016/S1262-3636(09)73458-5
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Aims Our studies were designed to understand the role of the gut hormones incretins GLP-1 and GIP on diabetes remission after gastric bypass surgery (GBP) Method Morbidly obese patients with type 2 diabetes (T2DM) were studied before and 1, 6, 12, 24 and 36 months after GBP A matched group of patients were Studied before and after a diet-induced 10 kg weight loss. equivalent to the weight loss 1 month after GBP All patients underwent an oral glucose tolerance test and in isoglycaemic glucose intravenous challenge to measure the incretin effect Results Post-prandial GLP-1 and GIP levels increase after GBP and the incretin effect on insulin secretion normalizes to the level of non diabetic controls In addition. the pattern of insulin secretion in response to oral glucose changes after GBP. with recovery of the early phase. and post-prandial glucose levels decrease significantly These changes were not seen after an equivalent weight loss by diet The changes in incretin levels and effect observed at 1 month are long lasting and persist up to 3 years after the surgery The improved insulin release and glucose tolerance after GBP were shown by others to be blocked by the administration of a GLP-1 antagonist in rodents, demonstrating, that these metabolic changes are. in part. GLP-1 dependent Conclusion Although sustained and significant weight loss is likely to be the key mediator of diabetes remission after GBP, the changes of incretins improve the early phase of insulin secretion and post-prandial glucose levels. and contribute to the better glucose tolerance (C) 2009 Published by Elsevier Masson SAS
引用
收藏
页码:513 / 517
页数:5
相关论文
共 42 条
[1]
Bariatric surgery: A systematic review and meta-analysis [J].
Buchwald, H ;
Avidor, Y ;
Braunwald, E ;
Jensen, MD ;
Pories, W ;
Fahrbach, K ;
Schoelles, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (14) :1724-1737
[2]
Duodenal-jejunal bypass for the treatment of type 2 diabetes in patients with body mass index of 22-34 kg/m2: a report of 2 cases [J].
Cohen, Ricardo V. ;
Schiavon, Carlos A. ;
Pinheiro, Jose S. ;
Correa, Jose Luiz ;
Rubino, Francesco .
SURGERY FOR OBESITY AND RELATED DISEASES, 2007, 3 (02) :195-197
[3]
Glucagon-Like Peptide-1 Protects β-Cells Against Apoptosis by Increasing the Activity of an Igf-2/Igf-1 Receptor Autocrine Loop [J].
Cornu, Marion ;
Yang, Jiang-Yan ;
Jaccard, Evrim ;
Poussin, Carine ;
Widmann, Christian ;
Thorens, Bernard .
DIABETES, 2009, 58 (08) :1816-1825
[4]
INCRETIN CONCEPT TODAY [J].
CREUTZFELDT, W .
DIABETOLOGIA, 1979, 16 (02) :75-85
[5]
Gastric bypass and nesidioblastosis - Too much of a good thing for islets? [J].
Cummings, DE .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (03) :300-302
[6]
ENTERAL ENHANCEMENT OF GLUCOSE DISPOSITION BY BOTH INSULIN-DEPENDENT AND INSULIN-INDEPENDENT PROCESSES - A PHYSIOLOGICAL-ROLE OF GLUCAGON-LIKE PEPTIDE-I [J].
DALESSIO, DA ;
PRIGEON, RL ;
ENSINCK, JW .
DIABETES, 1995, 44 (12) :1433-1437
[7]
Adjustable gastric banding and conventional therapy for type 2 diabetes - A randomized controlled trial [J].
Dixon, John B. ;
O'Brien, Paul E. ;
Playfair, Julie ;
Chapman, Leon ;
Schachter, Linda M. ;
Skinner, Stewart ;
Proietto, Joseph ;
Bailey, Michael ;
Anderson, Margaret .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2008, 299 (03) :316-323
[8]
EBERT R, 1987, Diabetes Metabolism Reviews, V3, P1
[9]
Glucagon-like peptide 1 inhibits cell apoptosis and improves glucose responsiveness of freshly isolated human islets [J].
Farilla, L ;
Bulotta, A ;
Hirshberg, B ;
Calzi, SL ;
Khoury, N ;
Noushmehr, H ;
Bertolotto, C ;
Di Mario, U ;
Harlan, DM ;
Perfetti, R .
ENDOCRINOLOGY, 2003, 144 (12) :5149-5158
[10]
The effect of physiological levels of glucagon-like peptide-1 on appetite, gastric emptying, energy and substrate metabolism in obesity [J].
Flint, A ;
Raben, A ;
Ersboll, AK ;
Holst, JJ ;
Astrup, A .
INTERNATIONAL JOURNAL OF OBESITY, 2001, 25 (06) :781-792