CONTEXT: Insulin resistance ameliorates after bariatric surgery, yet there is still a need for data on the acute effect of Roux-en-Y gastric bypass (RYGBP) on insulin sensitivity. OBJECTIVE: The objective of the study was to describe the acute effect of RYGBP on insulin sensitivity, measured by both the euglycemic-hyperinsulinemic clamp and homeostasis model assessment insulin resistance index (HOMA-IR). DESIGN AND SETTING: Evaluations were conducted before and 1 month after RYGBP at State University of Campinas (São Paulo, Brazil). PATIENTS: Patients included 19 premenopausal women with metabolic syndrome aged 35.3 (6.7) yr, body mass index 45.50 (3.74) kg/m2 [mean (sd)]. Six had mild type 2 diabetes, seven impaired glucose tolerance, and six normal glucose tolerance. INTERVENTIONS AND MAIN OUTCOME MEASURES: The volunteers underwent RYGBP either alone or combined with omentectomy. Euglycemic-hyperinsulinemic clamp, HOMA-IR, nonesterified fatty acids, leptin, ultrasensitive C-reactive protein, adiponectin, and IL-6 were assessed at baseline and 4.5 (0.9) wk postoperatively. RESULTS:Fasting glucose decreased [99.2 (13.1) to 83.6 (8.1) mg/dl, P<0.01] along with a reduction in fasting insulin [30.4 (17.0) to 11.4 (6.3) mU/liter, P<0.01]. M value did not improve postoperatively [25.82 (6.30) to 22.02 (6.05) micromol/kgFFM.min] despite of a decrease in body weight [114.8 (14.5) to 102.3 (14.5) kg, P<0.001]. This finding was discordant to the observation of an improvement in HOMA-IR [3.85 (2.10) to 1.42 (0.76), P<0.01]. Nonesterified fatty acids increased. Leptin and C-reactive protein decreased. IL-6 and adiponectin remained unchanged. CONCLUSIONS: A month after RYGBP, fasting glucose metabolism improves independent of a change in peripheral insulin sensitivity.
RCT Entities:
CONTEXT: Insulin resistance ameliorates after bariatric surgery, yet there is still a need for data on the acute effect of Roux-en-Y gastric bypass (RYGBP) on insulin sensitivity. OBJECTIVE: The objective of the study was to describe the acute effect of RYGBP on insulin sensitivity, measured by both the euglycemic-hyperinsulinemic clamp and homeostasis model assessment insulin resistance index (HOMA-IR). DESIGN AND SETTING: Evaluations were conducted before and 1 month after RYGBP at State University of Campinas (São Paulo, Brazil). PATIENTS: Patients included 19 premenopausal women with metabolic syndrome aged 35.3 (6.7) yr, body mass index 45.50 (3.74) kg/m2 [mean (sd)]. Six had mild type 2 diabetes, seven impaired glucose tolerance, and six normal glucose tolerance. INTERVENTIONS AND MAIN OUTCOME MEASURES: The volunteers underwent RYGBP either alone or combined with omentectomy. Euglycemic-hyperinsulinemic clamp, HOMA-IR, nonesterified fatty acids, leptin, ultrasensitive C-reactive protein, adiponectin, and IL-6 were assessed at baseline and 4.5 (0.9) wk postoperatively. RESULTS: Fasting glucose decreased [99.2 (13.1) to 83.6 (8.1) mg/dl, P<0.01] along with a reduction in fasting insulin [30.4 (17.0) to 11.4 (6.3) mU/liter, P<0.01]. M value did not improve postoperatively [25.82 (6.30) to 22.02 (6.05) micromol/kgFFM.min] despite of a decrease in body weight [114.8 (14.5) to 102.3 (14.5) kg, P<0.001]. This finding was discordant to the observation of an improvement in HOMA-IR [3.85 (2.10) to 1.42 (0.76), P<0.01]. Nonesterified fatty acids increased. Leptin and C-reactive protein decreased. IL-6 and adiponectin remained unchanged. CONCLUSIONS: A month after RYGBP, fasting glucose metabolism improves independent of a change in peripheral insulin sensitivity.
Authors: C Dirksen; N B Jørgensen; K N Bojsen-Møller; S H Jacobsen; D L Hansen; D Worm; J J Holst; S Madsbad Journal: Diabetologia Date: 2012-04-27 Impact factor: 10.122
Authors: Jonathan Foo; Jeremy Krebs; Mark Thomas Hayes; Damon Bell; Donia Macartney-Coxson; Tony Croft; Richard Strawson Stubbs Journal: Obes Surg Date: 2011-12 Impact factor: 4.129
Authors: Jonathan D Douros; Jingjing Niu; Sophia Sdao; Trillian Gregg; Kelsey Fisher-Wellman; Manish Bharadwaj; Anthony Molina; Ramamani Arumugam; MacKenzie Martin; Enrico Petretto; Matthew J Merrins; Mark A Herman; Jenny Tong; Jonathan Campbell; David D'Alessio Journal: JCI Insight Date: 2019-03-21
Authors: Juliet F Zechner; Uyenlinh L Mirshahi; Santhosh Satapati; Eric D Berglund; Jari Rossi; Michael M Scott; Christopher D Still; Glenn S Gerhard; Shawn C Burgess; Tooraj Mirshahi; Vincent Aguirre Journal: Gastroenterology Date: 2012-11-15 Impact factor: 22.682