GLP-1 Plays a Limited Role in Improved Glycemia Shortly After Roux-en-Y Gastric Bypass: A Comparison With Intensive Lifestyle Modification
| العنوان: | GLP-1 Plays a Limited Role in Improved Glycemia Shortly After Roux-en-Y Gastric Bypass: A Comparison With Intensive Lifestyle Modification |
|---|---|
| المؤلفون: | Reneé H. Moore, Thomas A. Wadden, Gary Korus, Marion L. Vetter, Scott Ritter, Raymond Carvajal, Zahra Khan, Karen L. Teff, Jesse Chittams, Kenric M. Murayama, Noel N. Williams, Alex Iagnocco, Michael R. Rickels |
| المصدر: | Diabetes |
| بيانات النشر: | American Diabetes Association, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Gastric Bypass, Incretin, 030209 endocrinology & metabolism, Incretins, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Glucagon-Like Peptide 1, Weight loss, Internal medicine, Internal Medicine, medicine, Humans, Insulin, Obesity, Life Style, 030304 developmental biology, Glycemic, 0303 health sciences, business.industry, digestive, oral, and skin physiology, Glucagon secretion, nutritional and metabolic diseases, Middle Aged, medicine.disease, Glucagon-like peptide-1, Metabolism, Endocrinology, Postprandial, Female, Insulin Resistance, medicine.symptom, business, hormones, hormone substitutes, and hormone antagonists |
| الوصف: | Rapid glycemic improvements following Roux-en-Y gastric bypass (RYGB) are frequently attributed to the enhanced GLP-1 response, but causality remains unclear. To determine the role of GLP-1 in improved glucose tolerance after surgery, we compared glucose and hormonal responses to a liquid meal test in 20 obese participants with type 2 diabetes mellitus who underwent RYGB or nonsurgical intensive lifestyle modification (ILM) (n = 10 per group) before and after equivalent short-term weight reduction. The GLP-1 receptor antagonist exendin(9–39)-amide (Ex-9) was administered, in random order and in double-blinded fashion, with saline during two separate visits after equivalent weight loss. Despite the markedly exaggerated GLP-1 response after RYGB, changes in postprandial glucose and insulin responses did not significantly differ between groups, and glucagon secretion was paradoxically augmented after RYGB. Hepatic insulin sensitivity also increased significantly after RYGB. With Ex-9, glucose tolerance deteriorated similarly from the saline condition in both groups, but postprandial insulin release was markedly attenuated after RYGB compared with ILM. GLP-1 exerts important insulinotropic effects after RYGB and ILM, but the enhanced incretin response plays a limited role in improved glycemia shortly after surgery. Instead, enhanced hepatic metabolism, independent of GLP-1 receptor activation, may be more important for early postsurgical glycemic improvements. |
| تدمد: | 1939-327X 0012-1797 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::015bb83f484032c5dc0e6bd85c0fd03bTest https://doi.org/10.2337/db14-0558Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....015bb83f484032c5dc0e6bd85c0fd03b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1939327X 00121797 |
|---|