Ankit Shah1, Marlena M Holter2, Fatima Rimawi2, Victoria Mark2, Roxanne Dutia2, James McGinty3, Bruce Levin4, Blandine Laferrère5,2. 1. Divison of Endocrinology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. 2. New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. 3. Bariatric Divsion, Department of Surgery, Mount Sinai St. Luke's, New York, NY. 4. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. 5. Divison of Endocrinology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY bbl14@columbia.edu.
Abstract
OBJECTIVE: Hepatic insulin clearance is a significant regulator of glucose homestasis. We hypothesized that the improvement in insulin clearance rates (ICRs) under fasting conditions and in response to oral and intravenous (IV) glucose would improve similarly after Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) as a function of weight loss; the difference in ICR after oral and IV glucose stimulation will be enhanced after RYGB compared with AGB, an effect mediated by glucagon-like peptide 1 (GLP-1). RESEARCH DESIGN AND METHODS: In study 1, the ICR was calculated under fasting condition (F-ICR), after oral glucose (O-ICR), and after an isoglycemic IV glucose clamp (IV-ICR) in individuals from an established cohort with type 2 diabetes mellitus (T2DM) before, after 10% matched weight loss, and 1 year after either RYGB (n = 22) or AGB (n = 12). In study 2, O-ICR was studied in a separate cohort of individuals with T2DM (n = 22), before and 3 months after RYGB, with and without exendin(9-39) infusion. RESULTS: In study 1, age, BMI, T2DM duration and control, and ICR did not differ between RYGB and AGB preintervention. Weight loss at 1 year was two times greater after RYGB than after AGB (31.6 ± 5.9% vs. 16.6 ± 9.8%; P < 0.05). RYGB and AGB both significantly increased F-ICR, O-ICR, and IV-ICR at 1 year. ICR was inversely associated with insulinemia. The difference between IV-ICR and O-ICR was significantly greater after RYGB versus AGB. GLP-1 antagonism with exendin(9-39) led to an increase in O-ICR in subjects post-RYGB. CONCLUSIONS: Weight loss increased ICR, an effect more pronounced after RYGB compared with AGB. Our data support a potential role for endogenous GLP-1 in the control of postprandial ICR after RYGB.
OBJECTIVE: Hepatic insulin clearance is a significant regulator of glucose homestasis. We hypothesized that the improvement in insulin clearance rates (ICRs) under fasting conditions and in response to oral and intravenous (IV) glucose would improve similarly after Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) as a function of weight loss; the difference in ICR after oral and IV glucose stimulation will be enhanced after RYGB compared with AGB, an effect mediated by glucagon-like peptide 1 (GLP-1). RESEARCH DESIGN AND METHODS: In study 1, the ICR was calculated under fasting condition (F-ICR), after oral glucose (O-ICR), and after an isoglycemic IV glucose clamp (IV-ICR) in individuals from an established cohort with type 2 diabetes mellitus (T2DM) before, after 10% matched weight loss, and 1 year after either RYGB (n = 22) or AGB (n = 12). In study 2, O-ICR was studied in a separate cohort of individuals with T2DM (n = 22), before and 3 months after RYGB, with and without exendin(9-39) infusion. RESULTS: In study 1, age, BMI, T2DM duration and control, and ICR did not differ between RYGB and AGB preintervention. Weight loss at 1 year was two times greater after RYGB than after AGB (31.6 ± 5.9% vs. 16.6 ± 9.8%; P < 0.05). RYGB and AGB both significantly increased F-ICR, O-ICR, and IV-ICR at 1 year. ICR was inversely associated with insulinemia. The difference between IV-ICR and O-ICR was significantly greater after RYGB versus AGB. GLP-1 antagonism with exendin(9-39) led to an increase in O-ICR in subjects post-RYGB. CONCLUSIONS: Weight loss increased ICR, an effect more pronounced after RYGB compared with AGB. Our data support a potential role for endogenous GLP-1 in the control of postprandial ICR after RYGB.
Authors: R Dutia; M Embrey; S O'Brien; R A Haeusler; K K Agénor; P Homel; J McGinty; R P Vincent; J Alaghband-Zadeh; B Staels; C W le Roux; J Yu; B Laferrère Journal: Int J Obes (Lond) Date: 2016-03 Impact factor: 5.095
Authors: Robert Caiazzo; Guillaume Lassailly; Emmanuelle Leteurtre; Gregory Baud; Hélène Verkindt; Violeta Raverdy; David Buob; Marie Pigeyre; Philippe Mathurin; François Pattou Journal: Ann Surg Date: 2014-11 Impact factor: 12.969
Authors: Aurora Merovci; Devjit Tripathy; Xi Chen; Ivan Valdez; Muhammad Abdul-Ghani; Carolina Solis-Herrera; Amalia Gastaldelli; Ralph A DeFronzo Journal: Diabetes Date: 2020-10-08 Impact factor: 9.461
Authors: Michele Schiavon; David Herzig; Matthias Hepprich; Marc Y Donath; Lia Bally; Chiara Dalla Man Journal: Front Endocrinol (Lausanne) Date: 2021-03-15 Impact factor: 5.555