Changes in glycemia, insulin and gut hormone responses to a slowly ingested solid low-carbohydrate mixed meal after laparoscopic gastric bypass or band surgery
Changes in glycemia, insulin and gut hormone responses to a slowly ingested solid low-carbohydrate mixed meal after laparoscopic gastric bypass or band surgery
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DOI：
10.1038/ijo.2017.22
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发表时间：
2017-05-01
影响因子：
4.9
通讯作者：
Krakoff, J.
中科院分区：
文献类型：
--
作者：
Bunt, J. C.;Blackstone, R.;Krakoff, J.
目的：评估腹腔镜可调节胃束带术（LAGB）或Roux-en-Y胃旁路术（RYGB）手术后，胰岛素生理学和肠道激素对易耐受和缓慢摄入固体、低碳水化合物混合餐试验（MMT）的早期变化。在肥胖、代谢健康患者（RYGB = 10 F或LAGB = 7 F/1 M）手术前和手术后4-8周测量血糖、胰岛素和c肽（以估计肝脏胰岛素提取; % HIE）、肠促胰岛素（GIP、aGLP-1）和胰多肽（PP）对MMT的反应。5例RYGB患者的基础内源性葡萄糖生成（EGP）和外周胰岛素作用（Rd =葡萄糖处置率）以及胰岛素代谢清除率（MCR-INS）的补充钳夹数据可用。结果：LAGB手术后，C肽和胰岛素MMT曲线（分别为P = 0.004和P = 0.0005）较低，% HIE无变化（P = 0.98）。相反，在RYGB受试者中，空腹血糖和胰岛素（三角形=-0.66 mmol l（-1），P
OBJECTIVE: To evaluate early changes in glycemia, insulin physiology and gut hormone responses to an easily tolerated and slowly ingested solid, low-carbohydrate mixed meal test (MMT) following laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass (RYGB) surgery.SUBJECTS/METHODS: This was a prospective non-randomized study. Plasma glucose, insulin and c-peptide (to estimate hepatic insulin extraction; % HIE), incretins (GIP, aGLP-1) and pancreatic polypeptide (PP) responses to the MMT were measured at 4-8 weeks before and after surgery in obese, metabolically healthy patients (RYGB = 10F or LAGB = 7F/1M). Supplementary clamp data on basal endogenous glucose production (EGP) and peripheral insulin action (Rd = rate of glucose disposal) and metabolic clearance rates of insulin (MCR-INS) were available in five of the RYGB patients. Repeated measures were appropriately accounted for in the analyses.RESULTS: Following LAGB surgery, C-peptide and insulin MMT profiles (P = 0.004 and P = 0.0005, respectively) were lower with no change in % HIE (P = 0.98). In contrast, in RYGB subjects, both fasting glucose and insulin (triangle =-0.66 mmol l(-1), P