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Liver blood dynamics after bariatric surgery : The effects of mixed-meal test and incretin infusions

Honka, Henri ; Koffert, Jukka ; Kauhanen, Saila ; Kudomi, Nobuyuki ; Hurme, Saija ; Mari, Andrea ; Lindqvist, Andreas LU ; Wierup, Nils LU ; Parkkola, Riitta and Groop, Leif LU , et al. (2018) In Endocrine Connections 7(7). p.888-896
Abstract

Aims/hypothesis: The mechanisms for improved glycemic control after bariatric surgery in subjects with type 2 diabetes (T2D) are not fully known. We hypothesized that dynamic hepatic blood responses to a mixed-meal are changed after bariatric surgery in parallel with an improvement in glucose tolerance. Methods: A total of ten morbidly obese subjects with T2D were recruited to receive a mixed-meal and a glucose-dependent insulinotropic polypeptide (GIP) infusion before and early after (within a median of less than three months) bariatric surgery, and hepatic blood flow and volume (HBV) were measured repeatedly with combined positron emission tomography/MRI. Ten lean non-diabetic individuals served as controls. Results: Bariatric surgery... (More)

Aims/hypothesis: The mechanisms for improved glycemic control after bariatric surgery in subjects with type 2 diabetes (T2D) are not fully known. We hypothesized that dynamic hepatic blood responses to a mixed-meal are changed after bariatric surgery in parallel with an improvement in glucose tolerance. Methods: A total of ten morbidly obese subjects with T2D were recruited to receive a mixed-meal and a glucose-dependent insulinotropic polypeptide (GIP) infusion before and early after (within a median of less than three months) bariatric surgery, and hepatic blood flow and volume (HBV) were measured repeatedly with combined positron emission tomography/MRI. Ten lean non-diabetic individuals served as controls. Results: Bariatric surgery leads to a significant decrease in weight, accompanied with an improved β-cell function and glucagon-like peptide 1 (GLP-1) secretion, and a reduction in liver volume. Blood flow in portal vein (PV) was increased by 1.65-fold (P = 0.026) in response to a mixed-meal in subjects after surgery, while HBV decreased in all groups (P < 0.001). When the effect of GIP infusion was tested separately, no change in hepatic arterial and PV flow was observed, but HBV decreased as seen during the mixed-meal test. Conclusions/interpretation: Early after bariatric surgery, PV flow response to a mixed-meal is augmented, improving digestion and nutrient absorption. GIP influences the post-prandial reduction in HBV thereby diverting blood to the extrahepatic sites.

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publication status
published
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keywords
Bariatric surgery, Glucose-dependent insulinotropic polypeptide, Hepatic blood volume, Portal vein blood flow, Positron emission tomography
in
Endocrine Connections
volume
7
issue
7
pages
9 pages
publisher
BioScientifica Ltd.
external identifiers
  • scopus:85064752594
ISSN
2049-3614
DOI
10.1530/EC-18-0234
language
English
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yes
id
862454a2-461a-45f6-8a1e-cb03155c30b2
date added to LUP
2019-05-08 09:36:29
date last changed
2020-01-22 07:34:45
@article{862454a2-461a-45f6-8a1e-cb03155c30b2,
  abstract     = {<p>Aims/hypothesis: The mechanisms for improved glycemic control after bariatric surgery in subjects with type 2 diabetes (T2D) are not fully known. We hypothesized that dynamic hepatic blood responses to a mixed-meal are changed after bariatric surgery in parallel with an improvement in glucose tolerance. Methods: A total of ten morbidly obese subjects with T2D were recruited to receive a mixed-meal and a glucose-dependent insulinotropic polypeptide (GIP) infusion before and early after (within a median of less than three months) bariatric surgery, and hepatic blood flow and volume (HBV) were measured repeatedly with combined positron emission tomography/MRI. Ten lean non-diabetic individuals served as controls. Results: Bariatric surgery leads to a significant decrease in weight, accompanied with an improved β-cell function and glucagon-like peptide 1 (GLP-1) secretion, and a reduction in liver volume. Blood flow in portal vein (PV) was increased by 1.65-fold (P = 0.026) in response to a mixed-meal in subjects after surgery, while HBV decreased in all groups (P &lt; 0.001). When the effect of GIP infusion was tested separately, no change in hepatic arterial and PV flow was observed, but HBV decreased as seen during the mixed-meal test. Conclusions/interpretation: Early after bariatric surgery, PV flow response to a mixed-meal is augmented, improving digestion and nutrient absorption. GIP influences the post-prandial reduction in HBV thereby diverting blood to the extrahepatic sites.</p>},
  author       = {Honka, Henri and Koffert, Jukka and Kauhanen, Saila and Kudomi, Nobuyuki and Hurme, Saija and Mari, Andrea and Lindqvist, Andreas and Wierup, Nils and Parkkola, Riitta and Groop, Leif and Nuutila, Pirjo},
  issn         = {2049-3614},
  language     = {eng},
  number       = {7},
  pages        = {888--896},
  publisher    = {BioScientifica Ltd.},
  series       = {Endocrine Connections},
  title        = {Liver blood dynamics after bariatric surgery : The effects of mixed-meal test and incretin infusions},
  url          = {http://dx.doi.org/10.1530/EC-18-0234},
  doi          = {10.1530/EC-18-0234},
  volume       = {7},
  year         = {2018},
}