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首页> 外文期刊>Diabetes care >Insulin Clearance After Oral and Intravenous Glucose Following Gastric Bypass and Gastric Banding Weight Loss
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Insulin Clearance After Oral and Intravenous Glucose Following Gastric Bypass and Gastric Banding Weight Loss

机译：胃旁路后口服和静脉内葡萄糖后的胰岛素清除，胃旁路和胃带状重量损失

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摘要

OBJECTIVEHepatic 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 METHODSIn 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.RESULTSIn 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.CONCLUSIONSWeight 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.
机译：目的的Hepatic胰岛素清除是葡萄糖宿主的重要调节剂。我们假设禁食条件下胰岛素清除率（ICR）的改善在Roux-Zh-Y胃旁路（RygB）和可调节的胃带（AGB）作为功能后，类似地改善了禁食条件下和口腔和静脉内（IV）葡萄糖的改善减肥;在RYGB与AGB比较后，将提高ICR和IV葡萄糖刺激后的差异，胰高血糖素肽1（GLP-1）介导的效果。研究设计和方法研究1，ICR在禁食条件下计算（F. -ICR），在口腔葡萄糖（O-ICR）之后，在具有2型糖尿病（T2DM）的型糖尿病（T2DM）中的个体中的异甘膜炎血糖夹（IV-ICR）之后，在10％匹配的体重减轻后，1 RYGB（n = 22）或AGB（n = 12）之后。在研究2中，在R2DM（n = 22）的单独个体队列中研究了O-ICR，在RYGB之前和3个月内，有和没有Exendin（9-39）输注。研究1，年龄，BMI，T2DM持续时间和控制，RYGB和AGB PRINTERENTER之间的ICR没有区别。在Rygb之后，1年的体重减轻比AgB之后较高两倍（31.6 5.9％与16.6 +/- 9.8％; P <0.05）。 RYGB和AGB在1年的1年度显着增加F-ICR，O-ICR和IV-ICR。 ICR与胰岛素血症相反。 RYGB与AGB之后，IV-ICR和O-ICR之间的差异显着更大。 GLP-1对抗蛋白（9-39）的拮抗作用导致rygB后的对象的O-ICR增加。CONCLUSIONS重量损失增加了ICR，与AGB相比，RYGB后更明显的效果更明显。我们的数据支持内源GLP-1在RYGB后对后催化ICR控制的潜在作用。

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  • 来源
    《Diabetes care》 |2019年第2期|共7页
  • 作者

    Shah Ankit; Holter Marlena M.; Rimawi Fatima; Mark Victoria; Dutia Roxanne; McGinty James; Levin Bruce; Laferrere Blandine;

  • 作者单位

    Columbia Univ Coll Phys &

    Surg Dept Med Divison Endocrinol New York NY 10032 USA;

    Columbia Univ Coll Phys &

    Surg Dept Med New York Obes Nutr Res Ctr New York NY 10032 USA;

    Columbia Univ Coll Phys &

    Surg Dept Med New York Obes Nutr Res Ctr New York NY 10032 USA;

    Columbia Univ Coll Phys &

    Surg Dept Med New York Obes Nutr Res Ctr New York NY 10032 USA;

    Columbia Univ Coll Phys &

    Surg Dept Med New York Obes Nutr Res Ctr New York NY 10032 USA;

    Mt Sinai St Lukes Dept Surg Bariatr Div New York NY USA;

    Columbia Univ Mailman Sch Publ Hlth Dept Biostat New York NY USA;

    Columbia Univ Coll Phys &

    Surg Dept Med Divison Endocrinol New York NY 10032 USA;

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  • 正文语种 eng
  • 中图分类 内分泌腺疾病及代谢病;
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