TY - JOUR

T1 - Matched weight loss induced by sleeve gastrectomy or gastric bypass similarly improves metabolic function in obese subjects

AU - Bradley, David

AU - Magkos, Faidon

AU - Eagon, J Christopher

AU - Varela, J Esteban

AU - Gastaldelli, Amalia

AU - Okunade, Adewole L

AU - Patterson, Bruce W

AU - Klein, Samuel

N1 - © 2014 The Obesity Society.

PY - 2014

Y1 - 2014

N2 - Objective: The effects of marked weight loss, induced by Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgeries, on insulin sensitivity, β-cell function and the metabolic response to a mixed meal were evaluated.Methods: Fourteen nondiabetic insulin-resistant patients who were scheduled to undergo SG (n = 7) or RYGB (n = 7) procedures completed a hyperinsulinemic-euglycemic clamp procedure and a mixed-meal tolerance test before surgery and after losing ∼20% of their initial body weight.Results: Insulin sensitivity (insulin-stimulated glucose disposal during a clamp procedure), oral glucose tolerance (postprandial plasma glucose area under the curve), and β-cell function (insulin secretion in relationship to insulin sensitivity) improved after weight loss, and were not different between surgical groups. The metabolic response to meal ingestion was similar after RYGB or SG, manifested by rapid delivery of ingested glucose into the systemic circulation and a large early postprandial increase in plasma glucose, insulin, and C-peptide concentrations in both groups.Conclusions: When matched on weight loss, RYGB and SG surgeries result in similar improvements in the two major factors involved in regulating plasma glucose homeostasis, insulin sensitivity and β-cell function in obese people without diabetes.

AB - Objective: The effects of marked weight loss, induced by Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgeries, on insulin sensitivity, β-cell function and the metabolic response to a mixed meal were evaluated.Methods: Fourteen nondiabetic insulin-resistant patients who were scheduled to undergo SG (n = 7) or RYGB (n = 7) procedures completed a hyperinsulinemic-euglycemic clamp procedure and a mixed-meal tolerance test before surgery and after losing ∼20% of their initial body weight.Results: Insulin sensitivity (insulin-stimulated glucose disposal during a clamp procedure), oral glucose tolerance (postprandial plasma glucose area under the curve), and β-cell function (insulin secretion in relationship to insulin sensitivity) improved after weight loss, and were not different between surgical groups. The metabolic response to meal ingestion was similar after RYGB or SG, manifested by rapid delivery of ingested glucose into the systemic circulation and a large early postprandial increase in plasma glucose, insulin, and C-peptide concentrations in both groups.Conclusions: When matched on weight loss, RYGB and SG surgeries result in similar improvements in the two major factors involved in regulating plasma glucose homeostasis, insulin sensitivity and β-cell function in obese people without diabetes.

KW - Adult

KW - Blood Glucose/metabolism

KW - C-Peptide/blood

KW - Case-Control Studies

KW - Female

KW - Gastrectomy/methods

KW - Gastric Bypass/methods

KW - Glucose Clamp Technique

KW - Glucose Tolerance Test

KW - Humans

KW - Insulin/blood

KW - Insulin Resistance

KW - Insulin-Secreting Cells/physiology

KW - Male

KW - Middle Aged

KW - Obesity, Morbid/metabolism

KW - Postprandial Period

KW - Weight Loss/physiology

U2 - 10.1002/oby.20803

DO - 10.1002/oby.20803

M3 - Journal article

C2 - 24891156

VL - 22

SP - 2026

EP - 2031

JO - Obesity

JF - Obesity

SN - 1930-7381

IS - 9

ER -