Early insulin sensitivity after restrictive bariatric surgery, inconsistency between HOMA-IR and steady-state plasma glucose levels
| Autor: | Janneke Wiebolt, Afra Koks, Jan Greve, Jeroen Nijhuis, Fred J. Prakken, Wim A. Buurman, Nicolaas C. Schaper, François M. H. van Dielen, Sander S. Rensen |
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| Přispěvatelé: | Algemene Heelkunde, Surgery, Interne Geneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: CAPHRI School for Public Health and Primary Care |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Weight loss Time Factors Gastroplasty Adhesion (medicine) WEIGHT-LOSS GASTRIC BYPASS-SURGERY ADHESION medicine.disease_cause Body Mass Index Morbid obesity Insulin resistance INFLAMMATION MARKERS MORBIDLY OBESE SUBJECTS medicine Humans Insulin Postoperative Period Postoperative SUPPRESSION business.industry Gastric bypass surgery RECOVERY Prognosis medicine.disease DISPOSAL Obesity Pathophysiology Obesity Morbid Surgery Disease Progression Homeostatic model assessment Female medicine.symptom business Body mass index RESISTANCE Follow-Up Studies |
| Zdroj: | Surgery for Obesity and Related Diseases, 6(4), 340-344. Elsevier Inc. |
| ISSN: | 1550-7289 |
| Popis: | Background The low-grade inflammatory condition present in morbid obesity is thought to play a causative role in the pathophysiology of insulin resistance (IR). Bariatric surgery fails to improve this inflammatory condition during the first months after surgery. Considering the close relation between inflammation and IR, we conducted a study in which insulin sensitivity was measured during the first months after bariatric surgery. Different methods to measure IR shortly after bariatric surgery have given inconsistent data. For example, the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels have been reported to decrease rapidly after bariatric surgery, although clamp techniques have shown sustained insulin resistance. In the present study, we evaluated the use of steady-state plasma glucose (SSPG) levels to assess insulin sensitivity 2 months after bariatric surgery. Methods Insulin sensitivity was measured using HOMA-IR and SSPG levels in 11 subjects before surgery and at 26% excess weight loss (approximately 2 months after restrictive bariatric surgery). Results The SSPG levels after 26% excess weight loss did not differ from the SSPG levels before surgery (14.3 ± 5.4 versus 14.4 ± 2.7 mmol/L). In contrast, the HOMA-IR values had decreased significantly (3.59 ± 1.99 versus 2.09 ± 1.02). Conclusion During the first months after restrictive bariatric surgery, we observed a discrepancy between the HOMA-IR and SSPG levels. In contrast to the HOMA-IR values, the SSPG levels had not improved, which could be explained by the ongoing inflammatory state after bariatric surgery. These results suggest that during the first months after restrictive bariatric surgery, HOMA-IR might not be an adequate marker of insulin sensitivity. |
| Databáze: | OpenAIRE |
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