Effects of Sleeve Gastrectomy and Medical Treatment for Obesity on Glucagon-like Peptide 1 Levels and Glucose Homeostasis in Non-diabetic Subjects
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Juan Patricio Valderas & Veronica Irribarra & Lorena Rubio & Camilo Boza & Manuel Escalona & Yessica Liberona & Andrea Matamala & Alberto Maiz
- چاپ و سال / کشور: 2011
Description
Background The effects of medical and surgical treatments for obesity on glucose metabolism and glucagon-like peptide 1 (GLP-1) levels independent of weight loss remain unclear. This study aims to assess plasma glucose levels, insulin sensitivity and secretion, and GLP-1 levels before and after sleeve gastrectomy (SG) or medical treatment (MED) for obesity. Methods This study is a prospective, controlled, nonrandomised study. Two groups of non-diabetic obese patients with similar BMIs, including a SG group (BMI, 35.5±0.9 kg/m2; n=6) and a MED group (BMI, 37.7± 1.9 kg/m2; n=6) and a group of lean subjects (BMI, 21.7± 0.7 kg/m2; n=8). Results Plasma glucose, insulin, and total GLP-1 levels at fasting and after the intake of a standard liquid meal at baseline and at 2 months post-intervention. At baseline, total GLP-1 levels were similar, but obese patients had lower insulin sensitivity and higher insulin secretion than lean subjects. At 2 months post-intervention, SG and MED patients achieved similar weight loss (14.4±0.8%, 15.3± 0.9%, respectively). Insulin sensitivity increased in SG and MED patients; however, postprandial insulin secretion decreased after MED, but not after SG. The incremental area under the curve of GLP-1 increased after SG (P=0.04), but not after MED. Conclusions Weight loss by medical or surgical treatment improved insulin sensitivity. However, only MED corrected the hyperinsulinemic postprandial state associated to obesity. Postprandial GLP-1 levels increased significantly after SG without duodenal exclusion, which may explain why insulin secretion did not decrease following this surgery.
OBES SURG (2011) 21:902–909 DOI 10.1007/s11695-011-0375-4 Published online: 24 February 2011
