Improvement in ß-cell function in patients with normal and hyperglycemia following Roux-en-Y gastric bypass surgery.
نویسندگان
چکیده
Glycemic disorders resolve following Roux-en-Y gastric bypass (RYGB) surgery, but early and longer-term mechanisms regarding effects on β-cell dysfunction as well as relationships with decreasing adiposity are not well understood. We evaluated longitudinal changes in peripheral insulin sensitivity (Si), the acute insulin response to glucose (AIRg), and the composite estimate of β-cell function, the disposition index (DI), over 24 mo via frequently sampled intravenous glucose tolerance testing in severely obese women who had fasting normoglycemia (n = 16) and hyperglycemia (n = 11) before RYGB surgery; homeostatic model assessment (HOMA-IR) estimated insulin resistance; air displacement plethysmography determined adipose tissue mass. At baseline, subjects with normoglycemia had adequate DI associated with elevated AIRg, but DI was markedly reduced in subjects with hyperglycemia. Within 1-6 mo post-RYGB, glycemic control was normalized in subjects with hyperglycemia related to reduced HOMA-IR (-54% at 1 mo, P < 0.005) and increased DI (23-fold at 6 mo vs. baseline, P < 0.05). Over 24 mo, DI improved in subjects with hyperglycemia (15-fold vs. baseline, P < 0.005) and also modestly in subjects with normoglycemia (58%, P < 0.05), due largely to increased Si. Decreasing adiposity correlated with longer-term HOMA-IR and Si values at 6 and 24 mo, respectively. In patients exhibiting fasting hyperglycemia before surgery, β-cell function improved early following RYGB, due largely to increases in insulin secretion. For both normoglycemic and hyperglycemic subjects, further improvement or stabilization of β-cell function over the 2 yr is due largely to improved Si associated with reduced adiposity.
منابع مشابه
Comparison of roux-en-y gastric bypass techniques with and without distal gastric plication in patients with morbid obesity
متن کامل
Cost-effectiveness of Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass in Patients with Morbid Obesity: A Systematic Review
Cost-effectiveness of Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass in Patients with Morbid Obesity: A Systematic Review Talebianpour Hamid1, Shahab Alizadeh2* 1. Ph.D. Student, School of Public Health, Department of Management Sciences and Health Economics, Tehran University of Medical Sciences, Tehran, Iran 2. Ph.D. Student, Faculty of Nutrition and Dietetic...
متن کاملLiver markers, prevalence of the metabolic syndrome abnormalities and effect of Roux-en-Y gastric bypass in morbidly obese subjects.
OBJECTIVES To evaluate the relations between liver markers (GGT, ALT and AST) and the metabolic syndrome (and its components) in morbidly obese subjects, and to determine the response of these metabolic factors and hepatic enzymes after weight loss induced by Roux-en-Y gastric bypass. METHODS This study was carried out at a university hospital, in Santo André (SP), Brazil. We evaluated 140 mo...
متن کاملImpact of Roux-en-y Gastric Bypass Surgery (rygb) on Metabolic Syndrome Components and on the Use of Associated Drugs in Obese Patients.
BACKGROUND The prevalence of obesity and metabolic syndrome is increasing worldwide and both behavior modification and drug therapy have low adherence. Gastric bypass has shown effective results in both reducing weight and improving comorbidities. OBJECTIVE To evaluate the impact of Roux-en-Y Gastric Bypass Surgery (RYGB) on both metabolic syndrome components and the use of associated drugs i...
متن کاملAdult onset nesidioblastosis after gastric bypass surgery, a clinical and pathologic review
Despite the many benefits of bariatric surgery in patients with morbid obesity, concerns have been raised over its association with severe hyperinsulinemic hypoglycemia and nesidioblastosis following Roux-en-Y gastric bypass surgery. Cases have been described with severe post-prandial hypoglycemia with neurological symptoms following surgery. Some of these cases are recalcitrant to medical trea...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- American journal of physiology. Endocrinology and metabolism
دوره 299 5 شماره
صفحات -
تاریخ انتشار 2010