Open AccessChanges of blood glucose and gastrointestinal hormones 4 months after R oux‐en‐ Y gastric bypass surgery in C hinese obese type 2 diabetes patients with lower body mass index
Author(s) -
Wu Qianlin,
Xiao Zhu,
Cheng Zhong,
Tian Haoming
Publication year - 2013
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12005
Subject(s) - medicine , glycated hemoglobin , body mass index , gastric bypass surgery , peptide yy , diabetes mellitus , type 2 diabetes , endocrinology , gastroenterology , type 2 diabetes mellitus , glucagon like peptide 1 , hormone , obesity , hemoglobin , gastric bypass , weight loss , receptor , neuropeptide y receptor , neuropeptide
Aims/Introduction The goal of this study was to evaluate the effect of R oux‐en‐ Y gastric bypass ( RYGB ) on hyperglycemia and gastrointestinal hormones in Chinese obese type 2 diabetic patients with body mass index ( BMI ) between 28 and 35 kg/m 2 . Materials and Methods A total of eight obese type 2 diabetes patients with BMI 28–35 kg/m 2 who underwent RYGB and 10 obese normal glucose tolerance ( NGT ) patients with no surgery were identified. BMI and blood glucose on baseline, and 2–4 months postoperative, changes of glucagon‐like peptide‐1 ( GLP ‐1), glucose‐dependent insulinotropic polypeptide ( GIP ), peptide YY ( PYY ), and oxyntomodulin ( OXM ) were recorded. Efficacy of RYGB was defined by the percentage of excess weight loss (% EWL ) and amelioration of type 2 diabetes. Results The %EWL was 53.00 ± 26.25% in 2 month and 63.65 ± 33.71% in 4 month. Glycated hemoglobin changed from 7.2 ± 1.0% preoperative to 6.2 ± 0.9% in 2 month and 6.3 ± 1.2% in 4 month postoperative. The improvement rate of type 2 diabetes 4 months after RYGB was 83.3%. After surgery, area under the curve ( AUC ) GLP ‐1 120 increased with no significance. AUC PYY 120 changed from 10.37 ± 5.45 pmol/ L /min preoperative to 22.19 ± 10.61 pmol/ L /min in 2 month and 22.04 ± 7.73 pmol/ L /min in 4 month postoperative. Postoperative AUC OXM 120 was also higher than that of the preoperative level. AUC GIP 120 decreased from 13.06 ± 8.45 pg/ mL /min preoperative to 8.71 ± 3.28 pg/ml/min in 2 month and 6.88 ± 2.33 pg/ mL /min in 4 month postoperative. Conclusions R oux‐en‐ Y gastric bypass has a beneficial effect on weight loss and glucose metabolism in obese type 2 diabetes patients with lower BMI . Postoperative concentrations of GLP ‐1, PYY and OXM increased, whereas GIP decreased.