Beta-cell sensitivity to glucose is impaired after gastric bypass surgery

被引:18
作者
Salehi, Marzieh [1 ]
Gastaldelli, Amalia [2 ]
D'Alessio, David A. [1 ]
机构
[1] Univ Cincinnati, Coll Med, Dept Med, Cincinnati, OH USA
[2] CNR, Inst Clin Physiol, Cardiometabol Risk Unit, Pisa, Italy
关键词
beta-cell glucose sensitivity; gastric bypass surgery; glucose tolerance; GLUCAGON-LIKE PEPTIDE-1; POSTPRANDIAL INSULIN-SECRETION; MORBIDLY OBESE SUBJECTS; BARIATRIC SURGERY; GLYCEMIC CONTROL; MEDICAL THERAPY; NORMAL HUMANS; WEIGHT-LOSS; TOLERANCE; CLEARANCE;
D O I
10.1111/dom.13165
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: Patients who have undergone Roux-en-Y gastric bypass surgery (GB) have exaggerated postprandial insulin secretion, which has been attributed to increased meal glucose appearance and enhanced incretin effect. Here, we sought to determine beta-cell glucose sensitivity in the absence of meal stimulation and insulinotropic gut factors. Materials and methods: A total of 12 non-diabetic subjects with prior GB, and 7 matched non-surgical control subjects with normal glucose tolerance were studied. Blood glucose and insulin secretion rates were measured during a graded glucose infusion at increasing and then decreasing rates. Insulin sensitivity (S-I) and glucose effectiveness (S-G) were determined by the minimal model. Results: GB subjects had S-I comparable to that of control subjects. GB subjects had relative hyperglycaemia during the highest dose of glucose infusion associated with significantly reduced beta-cell glucose sensitivity throughout both step-up (GB: 34 6, CN: 82 +/- 9 pmolmin(-1) mM(-1) L, P < .0001) and step-down (GB: 31 +/- 6, CN: 74 +/- 9 pmol min(-1) mM(-1) L, P < .0001) phases of the glucose infusion. GB subjects also had reduced S-G (GB: 0.04 +/- 0.00, CN: 0.07 +/- 0.01min(-1), P=.004). Conclusion: In the absence of enteric stimuli, beta-cell sensitivity to changes in g(l)ycaemia is blunted among individuals with GB, indicating a significant shift in a fundamental property of beta-cell function several years after surgery
引用
收藏
页码:872 / 878
页数:7
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