Insulin Sensitivity and β-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents
Autor: | Ronald L. Prigeon, Robert M. Cohen, Stavra A. Xanthakos, Stephen R. Daniels, Deborah A. Elder, Stephen C. Benoit, Thomas H. Inge, Todd M. Jenkins, Lawrence M. Dolan, David A. D'Alessio |
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Rok vydání: | 2014 |
Předmět: |
Blood Glucose
Male medicine.medical_specialty Pediatric Obesity Adolescent Gastric Bypass Article Body Mass Index chemistry.chemical_compound Young Adult Insulin resistance Internal medicine Diabetes mellitus Insulin-Secreting Cells medicine Humans Insulin Longitudinal Studies Prospective Studies Proinsulin Glucose tolerance test medicine.diagnostic_test C-peptide business.industry Type 2 Diabetes Mellitus Fasting Glucose Tolerance Test medicine.disease Obesity Endocrinology Treatment Outcome chemistry Pediatrics Perinatology and Child Health Female Insulin Resistance business Body mass index |
Zdroj: | The Journal of pediatrics. 167(5) |
ISSN: | 1097-6833 |
Popis: | To test the hypothesis that insulin secretion and insulin sensitivity would be improved in adolescents after Roux-en-Y gastric bypass (RYGB).A longitudinal study of 22 adolescents and young adults without diabetes undergoing laparoscopic RYGB (mean age 17.1 ± 1.42 years; range 14.5-20.1; male/female 8/14; Non-Hispanic White/African American 17/5) was conducted. Intravenous glucose tolerance tests were done to obtain insulin sensitivity (insulin sensitivity index), insulin secretion (acute insulin response to glucose ), and the disposition index as primary outcome variables. These variables were compared over the 1 year of observation using linear mixed modeling.In the 1-year following surgery, body mass index fell by 38% from a mean of 61 ± 12.3 to 39 ± 8.0 kg/m(2) (P.01). Over the year following surgery, fasting glucose and insulin values declined by 54% and 63%, respectively. Insulin sensitivity index increased 300% (P.01), acute insulin response to glucose decreased 56% (P.01), leading to a nearly 2-fold increase in the disposition index (P.01). Consistent with improved β-cell function, the proinsulin to C-peptide ratio decreased by 21% (P.01).RYGB reduced body mass index and improved both insulin sensitivity and β-cell function in severely obese teens and young adults. These findings demonstrate that RYGB is associated with marked metabolic improvements in obese young people even as significant obesity persists.ClinicalTrials.gov: NCT00360373. |
Databáze: | OpenAIRE |
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