Beta-cell sensitivity to glucose is impaired after gastric bypass surgery.
Beta-cell sensitivity to glucose is impaired after gastric bypass surgery.
复制标题
胃绕道手术后，β细胞对葡萄糖的敏感性受损。
DOI：
10.1111/dom.13165
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
D'Alessio,DavidA
中科院分区：
文献类型：
--
作者：
Salehi,Marzieh;Gastaldelli,Amalia;D'Alessio,DavidA
接受Roux-en-Y胃旁路手术（GB）的患者餐后胰岛素分泌增加，这归因于餐后葡萄糖增加和肠促胰岛素作用增强。在这里，我们试图确定β细胞葡萄糖敏感性在没有膳食刺激和促胰岛素肠道factors.Materials和methodsA共12个非糖尿病受试者与前GB，和7个匹配的非手术对照受试者与正常的葡萄糖耐量进行了研究。血糖和胰岛素分泌率在分级葡萄糖输注期间以先增加后降低的速率测量。胰岛素敏感性（SI）和葡萄糖的有效性（SG）测定的最小model.ResultsGB科目有SI与对照组。GB受试者在最高剂量葡萄糖输注期间出现相对高血糖症，与葡萄糖输注的递增（GB：34 ± 6，CN：82 ± 9 pmol min− 1 mM − 1 L，P< .0001）和递减（GB：31 ± 6，CN：74 ± 9 pmol min− 1 mM − 1 L，P< .0001）阶段的β细胞葡萄糖敏感性显著降低相关。GB受试者的SG也降低（GB：0.04 ± 0.00，CN：0.07 ± 0.01 min-1，P= .004）。结论在没有肠道刺激的情况下，GB患者的β细胞对血肌酐变化的敏感性减弱，表明手术后几年β细胞功能的基本特性发生了显著变化
AimsPatients who have undergone Roux‐en‐Y gastric bypass surgery (GB) have exaggerated postprandial insulin secretion, which has been attributed to increased meal glucose appearance and enhanced incretin effect. Here, we sought to determine β‐cell glucose sensitivity in the absence of meal stimulation and insulinotropic gut factors.Materials and methodsA total of 12 non‐diabetic subjects with prior GB, and 7 matched non‐surgical control subjects with normal glucose tolerance were studied. Blood glucose and insulin secretion rates were measured during a graded glucose infusion at increasing and then decreasing rates. Insulin sensitivity (SI) and glucose effectiveness (SG) were determined by the minimal model.ResultsGB subjects had SIcomparable to that of control subjects. GB subjects had relative hyperglycaemia during the highest dose of glucose infusion associated with significantly reduced β‐cell glucose sensitivity throughout both step‐up (GB: 34 ± 6, CN: 82 ± 9 pmol min−1mM−1L,P< .0001) and step‐down (GB: 31 ± 6, CN: 74 ± 9 pmol min−1mM−1L,P< .0001) phases of the glucose infusion. GB subjects also had reduced SG(GB: 0.04 ± 0.00, CN: 0.07 ± 0.01 min−1,P= .004).ConclusionIn the absence of enteric stimuli, β‐cell sensitivity to changes in glycaemia is blunted among individuals with GB, indicating a significant shift in a fundamental property of β‐cell function several years after surgery