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Dissociated incretin response to oral glucose at 1 year after restrictive vs. malabsorptive bariatric surgery

Guldstrand, M.; Ahrén, Bo LU ; Naslund, E.; Holst, J. J. and Adamson, U. (2009) In Diabetes, Obesity and Metabolism 11(11). p.1027-1033
Abstract
Aim Compare the response to oral glucose of the two incretin hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) at 1 year after restrictive vs. malabsorptive bariatric surgery. Methods Vertical banded gastroplasty (VBG, n = 7) or jejunoileal bypass (JIB, n = 5) was performed in 12 women, aged 26-39 years, with severe obesity [body mass index (BMI) 46.6 +/- 2.3 kg/m2]. After 1 year, 75 g glucose was administered and plasma levels of glucose, insulin, GIP and GLP-1 were determined regularly during the following 2 h. Results At 1 year after operation, reduction in body weight, actual body weight, fasting glucose or insulin, or the glucose and insulin responses to oral glucose did not differ... (More)
Aim Compare the response to oral glucose of the two incretin hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) at 1 year after restrictive vs. malabsorptive bariatric surgery. Methods Vertical banded gastroplasty (VBG, n = 7) or jejunoileal bypass (JIB, n = 5) was performed in 12 women, aged 26-39 years, with severe obesity [body mass index (BMI) 46.6 +/- 2.3 kg/m2]. After 1 year, 75 g glucose was administered and plasma levels of glucose, insulin, GIP and GLP-1 were determined regularly during the following 2 h. Results At 1 year after operation, reduction in body weight, actual body weight, fasting glucose or insulin, or the glucose and insulin responses to oral glucose did not differ significantly between the groups. Similarly, fasting GIP and GLP-1 levels did not differ significantly between the groups. In contrast, the GIP and GLP-1 responses to oral glucose were different between the groups in a dissociated pattern. Thus, AUC(GIP) was significantly higher after VBG than after JIB (53 +/- 8 vs. 26 +/- 6 pmol/l/min, p = 0.003). In contrast, AUC(GLP-1) was significantly higher after JIB than after VBG (49 +/- 5 vs. 20 +/- 3 pmol/l/min, p = 0.007). Conclusions We conclude that at 1 year after bariatric surgery, the two incretins show dissociated responses in that the GIP secretion is higher after VBG whereas GLP-1 secretion is higher after JIB. This dissociated incretin response is independent from reduction in body weight, glucose tolerance or insulin secretion. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
glucose tolerance, peptide-1, glucagon-like, GLP-1, glucose-dependent insulinotropic polypeptide, GIP, insulin, obesity, weight reduction
in
Diabetes, Obesity and Metabolism
volume
11
issue
11
pages
1027 - 1033
publisher
Wiley-Blackwell
external identifiers
  • wos:000270234800005
  • scopus:70350192133
ISSN
1462-8902
DOI
10.1111/j.1463-1326.2009.01089.x
language
English
LU publication?
yes
id
0bede272-42fc-4849-bd7a-b2e568fa82c0 (old id 1489781)
date added to LUP
2009-10-21 12:00:01
date last changed
2017-02-19 03:35:33
@article{0bede272-42fc-4849-bd7a-b2e568fa82c0,
  abstract     = {Aim Compare the response to oral glucose of the two incretin hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) at 1 year after restrictive vs. malabsorptive bariatric surgery. Methods Vertical banded gastroplasty (VBG, n = 7) or jejunoileal bypass (JIB, n = 5) was performed in 12 women, aged 26-39 years, with severe obesity [body mass index (BMI) 46.6 +/- 2.3 kg/m2]. After 1 year, 75 g glucose was administered and plasma levels of glucose, insulin, GIP and GLP-1 were determined regularly during the following 2 h. Results At 1 year after operation, reduction in body weight, actual body weight, fasting glucose or insulin, or the glucose and insulin responses to oral glucose did not differ significantly between the groups. Similarly, fasting GIP and GLP-1 levels did not differ significantly between the groups. In contrast, the GIP and GLP-1 responses to oral glucose were different between the groups in a dissociated pattern. Thus, AUC(GIP) was significantly higher after VBG than after JIB (53 +/- 8 vs. 26 +/- 6 pmol/l/min, p = 0.003). In contrast, AUC(GLP-1) was significantly higher after JIB than after VBG (49 +/- 5 vs. 20 +/- 3 pmol/l/min, p = 0.007). Conclusions We conclude that at 1 year after bariatric surgery, the two incretins show dissociated responses in that the GIP secretion is higher after VBG whereas GLP-1 secretion is higher after JIB. This dissociated incretin response is independent from reduction in body weight, glucose tolerance or insulin secretion.},
  author       = {Guldstrand, M. and Ahrén, Bo and Naslund, E. and Holst, J. J. and Adamson, U.},
  issn         = {1462-8902},
  keyword      = {glucose tolerance,peptide-1,glucagon-like,GLP-1,glucose-dependent insulinotropic polypeptide,GIP,insulin,obesity,weight reduction},
  language     = {eng},
  number       = {11},
  pages        = {1027--1033},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetes, Obesity and Metabolism},
  title        = {Dissociated incretin response to oral glucose at 1 year after restrictive vs. malabsorptive bariatric surgery},
  url          = {http://dx.doi.org/10.1111/j.1463-1326.2009.01089.x},
  volume       = {11},
  year         = {2009},
}