Gastric bypass and banding equally improve insulin sensitivity and β cell function

David Bradley, Caterina Conte, Bettina Mittendorfer, J. Christopher Eagon, J. Esteban Varela, Elisa Fabbrini, Amalia Gastaldelli, Kari T. Chambers, Xiong Su, Adewole Okunade, Bruce W. Patterson, Samuel Klein

Research output: Contribution to journalArticle

180 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)4667-4674
Number of pages8
JournalTHE JOURNAL OF CLINICAL INVESTIGATION
Volume122
DOIs
Publication statusPublished - 2012
Externally publishedYes

Keywords

  • Adult
  • Antigens, CD11b
  • Area Under Curve
  • Body Composition
  • Ceramides
  • Cytokines
  • Diglycerides
  • Female
  • Gastric Bypass
  • Gastroplasty
  • Humans
  • Inflammation Mediators
  • Insulin
  • Insulin Resistance
  • Insulin-Secreting Cells
  • Intra-Abdominal Fat
  • Male
  • Membrane Glycoproteins
  • Middle Aged
  • Mucins
  • Muscle, Skeletal
  • Obesity
  • Organ Size
  • Postprandial Period
  • Receptors, G-Protein-Coupled
  • Weight Loss

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