TY - JOUR
T1 - Gastric bypass and banding equally improve insulin sensitivity and β cell function
AU - Bradley, David
AU - Conte, Caterina
AU - Mittendorfer, Bettina
AU - Eagon, J. Christopher
AU - Varela, J. Esteban
AU - Fabbrini, Elisa
AU - Gastaldelli, Amalia
AU - Chambers, Kari T.
AU - Su, Xiong
AU - Okunade, Adewole
AU - Patterson, Bruce W.
AU - Klein, Samuel
PY - 2012/12/3
Y1 - 2012/12/3
N2 - Bariatric surgery in obese patients is a highly effective method of preventing or resolving type 2 diabetes mellitus (T2DM); however, the remission rate is not the same among different surgical procedures. We compared the effects of 20% weight loss induced by laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass (RYGB) surgery on the metabolic response to a mixed meal, insulin sensitivity, and β cell function in nondiabetic obese adults. The metabolic response to meal ingestion was markedly different after RYGB than after LAGB surgery, manifested by rapid delivery of ingested glucose into the systemic circulation, by an increase in the dynamic insulin secretion rate, and by large, early postprandial increases in plasma glucose, insulin, and glucagon-like peptide-1 concentrations in the RYGB group. However, the improvement in oral glucose tolerance, insulin sensitivity, and overall β cell function after weight loss were not different between surgical groups. Additionally, both surgical procedures resulted in a similar decrease in adipose tissue markers of inflammation. We conclude that marked weight loss itself is primarily responsible for the therapeutic effects of RYGB and LAGB on insulin sensitivity, β cell function, and oral glucose tolerance in nondiabetic obese adults.
AB - Bariatric surgery in obese patients is a highly effective method of preventing or resolving type 2 diabetes mellitus (T2DM); however, the remission rate is not the same among different surgical procedures. We compared the effects of 20% weight loss induced by laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass (RYGB) surgery on the metabolic response to a mixed meal, insulin sensitivity, and β cell function in nondiabetic obese adults. The metabolic response to meal ingestion was markedly different after RYGB than after LAGB surgery, manifested by rapid delivery of ingested glucose into the systemic circulation, by an increase in the dynamic insulin secretion rate, and by large, early postprandial increases in plasma glucose, insulin, and glucagon-like peptide-1 concentrations in the RYGB group. However, the improvement in oral glucose tolerance, insulin sensitivity, and overall β cell function after weight loss were not different between surgical groups. Additionally, both surgical procedures resulted in a similar decrease in adipose tissue markers of inflammation. We conclude that marked weight loss itself is primarily responsible for the therapeutic effects of RYGB and LAGB on insulin sensitivity, β cell function, and oral glucose tolerance in nondiabetic obese adults.
UR - http://www.scopus.com/inward/record.url?scp=84870542506&partnerID=8YFLogxK
U2 - 10.1172/JCI64895
DO - 10.1172/JCI64895
M3 - Article
C2 - 23187122
AN - SCOPUS:84870542506
SN - 0021-9738
VL - 122
SP - 4667
EP - 4674
JO - Journal of Clinical Investigation
JF - Journal of Clinical Investigation
IS - 12
ER -