Biliopancreatic Diversion Induces Greater Metabolic Improvement Than Roux-en-Y Gastric Bypass

被引：29

作者：

Harris, Lydia-Ann ^{[1
]}

Kayser, Brandon D. ^{[1
]}

Cefalo, Consuelo ^{[2
]}

Marini, Luca ^{[2
]}

Watrous, Jeramie D. ^{[3
,4
]}

Ding, Jeffrey ^{[3
,4
]}

Jain, Mohit ^{[3
,4
]}

McDonald, Jeffrey G. ^{[5
]}

Thompson, Bonne M. ^{[5
]}

Fabbrini, Elisa ^{[1
,6
]}

Eagon, J. Christopher ^{[7
]}

Patterson, Bruce W. ^{[1
]}

Mittendorfer, Bettina ^{[1
]}

Mingrone, Geltrude ^{[2
]}

Klein, Samuel ^{[1
,3
,4
]}

机构：

[1] Washington Univ, Sch Med, Ctr Human Nutr, St Louis, MO 63110 USA

[2] Catholic Univ, Dept Internal Med, Sch Med, Rome, Italy

[3] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA

[4] Univ Calif San Diego, Dept Pharmacol, San Diego, CA 92103 USA

[5] Univ Texas Southwestern, Ctr Human Nutr, Dallas, TX USA

[6] Janssen R&D, Raritan, NJ USA

[7] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA

来源：

CELL METABOLISM | 2019年 / 30卷 / 05期

基金：

美国国家卫生研究院;

关键词：

WEIGHT-LOSS; BILE-ACIDS; INSULIN-RESISTANCE; BARIATRIC SURGERY; MEDICAL THERAPY; GLUCOSE; PHOSPHATIDYLCHOLINE; COMPLICATIONS; COMBINATION; SENSITIVITY;

D O I：

10.1016/j.cmet.2019.09.002

中图分类号：

Q2 [细胞生物学];

学科分类号：

071009 ; 090102 ;

摘要：

Diabetes remission is greater after biliopancreatic diversion (BPD) than Roux-en-Y gastric bypass (RYGB) surgery. We used a mixed-meal test with ingested and infused glucose tracers and the hyperinsulinemic-euglycemic clamp procedure with glucose tracer infusion to assess the effect of 20% weight loss induced by either RYGB or BPD on glucoregulation in people with obesity (ClinicalTrials.gov number: NCT03111953). The rate of appearance of ingested glucose into the circulation was much slower, and the postprandial increases in plasma glucose and insulin concentrations were markedly blunted after BPD compared to after RYGB. Insulin sensitivity, assessed as glucose disposal rate during insulin infusion, was similar to 45% greater after BPD than RYGB, whereas beta cell function was not different between groups. These results demonstrate that compared with matched-percentage weight loss induced by RYGB, BPD has unique beneficial effects on glycemic control, manifested by slower postprandial glucose absorption, blunted postpran- dial plasma glucose and insulin excursions, and greater improvement in insulin sensitivity.

引用

页码：855 / +

页数：13

共 50 条

[1] Roux-en-Y gastric bypass normalizes the blunted postprandial bile acid excursion associated with obesity [J].