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. 2007 Nov-Dec;3(6):597-601.
doi: 10.1016/j.soard.2007.08.004. Epub 2007 Oct 23.

Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide secretion are associated with Roux-en-Y gastric bypass but not adjustable gastric banding

Judith Korner  1 , Marc Bessler, William Inabnet, Carmen Taveras, Jens Juul Holst
Affiliations

Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide secretion are associated with Roux-en-Y gastric bypass but not adjustable gastric banding

Judith Korner et al. Surg Obes Relat Dis. 2007 Nov-Dec.

Abstract

Background: The aim of this study was to measure the circulating levels of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and glucagon in patients who had undergone adjustable gastric banding (BND) or Roux-en-Y gastric bypass (RYGB) to understand the differences in glucose and insulin regulation after these procedures.

Methods: This was a cross-sectional study of 3 groups of women matched for age and body mass index: group 1, overweight controls (n = 13); group 2, BND (n = 10); and group 3, RYGB (n = 13). Venous blood was drawn with the patient in the fasted state and throughout a 3-hour period after a liquid meal.

Results: The fasting glucose level was similar between the 2 surgery groups; however, the fasting insulin concentrations were greater in the BND (10.0 microU/mL) than in the RYGB (6.2 microU/mL; P <0.05) group. The glucose level at 60 minutes was significantly lower in the RYGB group (70 mg/dL, range 38-82) than in the BND group (83 mg/dL, range 63-98). The GLP-1 levels at 30 minutes were more than threefold greater in the RYGB group (96 pmol/L) compared with the BND and overweight control (28 pmol/L) groups. The GLP-1 and insulin concentrations correlated at 30 minutes only in the RYGB group (r = .66; P = .013). The glucose-dependent insulinotropic peptide levels at 30 minutes were lower in the RYGB group (20 pmol/L) than in the BND group (31 pmol/L) or overweight control group (33 pmol/L). The peak glucagon levels were similar among the 3 groups.

Conclusion: Exaggerated postprandial GLP-1 and blunted glucose-dependent insulinotropic peptide secretion after RYGB might contribute to the greater weight loss and improved glucose homeostasis compared with BND.

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Figures

Fig. 1
Fig. 1
Circulating concentrations of glucose (A), insulin (B), GLP-1 (C), and GIP (E) in response to a test meal.φ,P<0.05 for OW vs RYGB; *,P<0.05 for BND vs RYGB. AUC from fasting to 180 minutes post-meal of GLP-1 (D) and GIP (F). +,P<0.05; ++,P<0.01; +++,P<0.001 vs. bypass.
Fig. 2
Fig. 2
Circulating concentrations of glucagon in response to a test meal.φ,P<0.05 for OW vs RYGB; *P<0.05 for BND vs RYGB.
See this image and copyright information in PMC

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