Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after Roux-en-Y gastric bypass.
Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after Roux-en-Y gastric bypass.
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作者：
Shah M;Law JH;Micheletto F;Sathananthan M;Dalla Man C;Cobelli C;Rizza RA;Camilleri M;Zinsmeister AR;Vella A
胰高血糖素样肽1（GLP-1）升高对Roux-en-Y胃旁路术（RYGB）后餐后葡萄糖代谢的贡献一直是不确定的主题。我们使用exendin-9，39（GLP-1的竞争性拮抗剂）检测RYGB后受试者和匹配对照受试者的葡萄糖代谢、胰岛激素分泌和胃肠转运。在存在或不存在以300 pmol/kg/min输注Exendin-9，39的情况下研究受试者。Exendin-9，39导致RYGB后综合餐后葡萄糖浓度增加（3.6 ± 0.5 vs. 2.0 ± 0.4 mol/6 h，P = 0.001）。Exendin-9，39降低了胰岛素浓度（12.3 ± 2.2 vs. 18.1 ± 3.1 nmol/6 h，P = 0.002）和β细胞对葡萄糖的反应（β细胞总数，13 ± 1 vs. 11 ± 1 × 10−9 min−1，P = 0.01），但没有改变处置指数（DI）。在对照受试者中，毒蜥外泌肽-9，39也增加葡萄糖（2.2 ± 0.4对1.7 ± 0.3 mol/6 h，P = 0.03），而不伴随胰岛素浓度的变化，导致DI受损。RYGB后，在前30分钟内exendin-9，39对胃排空的加速并没有改变进餐外观，同样，在RYGB受试者中，葡萄糖产生的抑制和葡萄糖消失的刺激也没有改变。这些数据表明，内源性GLP-1对葡萄糖代谢和RYGB后数年的胃肠动力有影响。然而，目前还不确定这是否解释了RYGB之后的所有变化。
The contribution of elevated glucagon-like peptide 1 (GLP-1) to postprandial glucose metabolism after Roux-en-Y gastric bypass (RYGB) has been the subject of uncertainty. We used exendin-9,39, a competitive antagonist of GLP-1, to examine glucose metabolism, islet hormone secretion, and gastrointestinal transit in subjects after RYGB and in matched control subjects. Subjects were studied in the presence or absence of exendin-9,39 infused at 300 pmol/kg/min. Exendin-9,39 resulted in an increase in integrated postprandial glucose concentrations post-RYGB (3.6 ± 0.5 vs. 2.0 ± 0.4 mol/6 h, P = 0.001). Exendin-9,39 decreased insulin concentrations (12.3 ± 2.2 vs. 18.1 ± 3.1 nmol/6 h, P = 0.002) and the β-cell response to glucose (ϕTotal, 13 ± 1 vs. 11 ± 1 × 10−9 min−1, P = 0.01) but did not alter the disposition index (DI). In control subjects, exendin-9,39 also increased glucose (2.2 ± 0.4 vs. 1.7 ± 0.3 mol/6 h, P = 0.03) without accompanying changes in insulin concentrations, resulting in an impaired DI. Post-RYGB, acceleration of stomach emptying during the first 30 min by exendin-9,39 did not alter meal appearance, and similarly, suppression of glucose production and stimulation of glucose disappearance were unaltered in RYGB subjects. These data indicate that endogenous GLP-1 has effects on glucose metabolism and on gastrointestinal motility years after RYGB. However, it remains uncertain whether this explains all of the changes after RYGB.
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影响因子：
16.2
作者：
Kashyap SR;Bhatt DL;Wolski K;Watanabe RM;Abdul-Ghani M;Abood B;Pothier CE;Brethauer S;Nissen S;Gupta M;Kirwan JP;Schauer PR
通讯作者：
Schauer PR
影响因子：
5.8
作者：
Laferrere, Blandine;Teixeira, Julio;Olivan, Blanca
通讯作者：
Olivan, Blanca
影响因子：
2.9
作者：
FICH, A;NERI, M;PHILLIPS, SF
通讯作者：
PHILLIPS, SF
影响因子：
15.9
作者：
Basu, A;Alzaid, A;Rizza, RA
通讯作者：
Rizza, RA
影响因子：
5.8
作者：
Deane, Adam M.;Nguyen, Nam Q.;Horowitz, Michael
通讯作者：
Horowitz, Michael