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- Title
ENDOCRINE CONSEQUENCES OF BARIATRIC SURGERY IN MORBID OBESITY.
- Authors
Micić, Dragan D.
- Abstract
Gastric bypass procedures started to replace jejunoileal bypass procedures in 1970, leading to weight loss due to restriction of food intake because of reduced gastric pouch, reduced size of gastroenterostomy and malabsorption of macronutritiens as well as and changes in intestinal hormones that were responsible also for weight loss and reduction of food intake. Recently, there were a couple of well designed studies that documented improvement of Type 2 diabetes after metabolic surgery, connected even with the partial or complete remission of diabetes. Various hypothesis exist about the mehanism of glycemic control after bariatric surgery involving intestinal bypass. In our series of morbidly obese patients, we determined GLP-1 response after test meal ( Fresubin drink a 200 ml; 200 kcal, 15 % protein, 30% fat and 55 % carbohydrate) before (day 0) and 5 and 90 days after gastric by pass surgery. Glycaemia (mmol/l; glucose oxidase) and GLP-1 (Active 7-36) (pM/l; ELISA, ALPCO diagnostics) were determined in 8 obese patients (age: 31.1±14,0; BMI: 42,7±7.2 kg/m2) in three separate days in 0, 15, 30, 45, 60, 90 and 120 min. There were no significant difference between area under the glucose curve (X ± SD) ( 652.65±57.12 vs 574.80±72.96 vs 572.62±68.36 mmol/l x min-1; p >0.05) in respective day intervals, while there was significant increase in area under the GLP-1 curve (pmol/l x min-1) in days 5 (861.94±251.22) and 90 (664.12±124.36) in comparison with day 0 (163,00±73.61 ) (p < 0.05). There were no significant differences between basal glucose and GLP-1 levels (0.56±0.25; 0.95±0.17; 0.35±0.14; p > 0.05) while there was significant increase in peak GLP-1 levels in day 5 (21.28±3.23) and day 90 ( 26.52±4.36) in comparison with day 0 (1.97±0.30) (p<0.05). We conclude that GLP-1 response after test meal is significantly increased after gastric by pass surgery early (after 5 days) and lately (after 90 days). The observed improvement in GLP-1 response after test meal after gastric by pass surgery may be responsible for the metabolic effects of bariatric surgery.
- Subjects
WEIGHT loss endocrinology; BARIATRIC surgery; JEJUNOILEAL bypass; TYPE 2 diabetes; FOOD consumption
- Publication
Medical Gazette / Medicinski Glasnik, 2012, Vol 17, Issue 46S, p58
- ISSN
1821-1925
- Publication type
Article