Contribution of Endogenous Glucagon-Like Peptide 1 to Glucose Metabolism After Roux-en-Y Gastric Bypass
| Autor: | Meera Shah, Claudio Cobelli, Robert A. Rizza, Michael Camilleri, Jennie H. Law, Alan R. Zinsmeister, Chiara Dalla Man, Matheni Sathananthan, Adrian Vella, Francesco Micheletto |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastric Bypass 030209 endocrinology & metabolism Stimulation Carbohydrate metabolism Biology 03 medical and health sciences 0302 clinical medicine Glucagon-Like Peptide 1 Internal medicine Internal Medicine medicine Humans 030304 developmental biology 0303 health sciences geography geography.geographical_feature_category Insulin digestive oral and skin physiology nutritional and metabolic diseases Islet Glucagon-like peptide-1 Peptide Fragments Stomach emptying Postprandial Endocrinology Metabolism Glucose Gene Expression Regulation Case-Control Studies Female Hormone |
| Zdroj: | Diabetes |
| Popis: | The contribution of elevated glucagon-like peptide 1 (GLP-1) to postprandial glucose metabolism after Roux-en-Y gastric bypass (RYGB) has been the subject of uncertainty. We used exendin-9,39, a competitive antagonist of GLP-1, to examine glucose metabolism, islet hormone secretion, and gastrointestinal transit in subjects after RYGB and in matched control subjects. Subjects were studied in the presence or absence of exendin-9,39 infused at 300 pmol/kg/min. Exendin-9,39 resulted in an increase in integrated postprandial glucose concentrations post-RYGB (3.6 ± 0.5 vs. 2.0 ± 0.4 mol/6 h, P = 0.001). Exendin-9,39 decreased insulin concentrations (12.3 ± 2.2 vs. 18.1 ± 3.1 nmol/6 h, P = 0.002) and the β-cell response to glucose (ϕTotal, 13 ± 1 vs. 11 ± 1 × 10−9 min−1, P = 0.01) but did not alter the disposition index (DI). In control subjects, exendin-9,39 also increased glucose (2.2 ± 0.4 vs. 1.7 ± 0.3 mol/6 h, P = 0.03) without accompanying changes in insulin concentrations, resulting in an impaired DI. Post-RYGB, acceleration of stomach emptying during the first 30 min by exendin-9,39 did not alter meal appearance, and similarly, suppression of glucose production and stimulation of glucose disappearance were unaltered in RYGB subjects. These data indicate that endogenous GLP-1 has effects on glucose metabolism and on gastrointestinal motility years after RYGB. However, it remains uncertain whether this explains all of the changes after RYGB. |
| Databáze: | OpenAIRE |
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