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Dissociated incretin response to oral glucose at 1 year after restrictive vs. malabsorptive bariatric surgery
Author(s) -
Guldstrand M.,
Ahrén B.,
Näslund E.,
Holst J. J.,
Adamson U.
Publication year - 2009
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2009.01089.x
Subject(s) - incretin , medicine , endocrinology , gastric inhibitory polypeptide , glucagon like peptide 1 , insulin , jejunoileal bypass , obesity , weight loss , body mass index , glucagon , diabetes mellitus , type 2 diabetes , morbid obesity
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/m 2 ]. 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.