| Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans. | |
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MedLine Citation:
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PMID: 21868791 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Gastric bypass (GB) surgery is associated with postprandial hyperinsulinemia, and this effect is accentuated in postsurgical patients who develop recurrent hypoglycemia. Plasma levels of the incretin glucagon-like peptide 1 (GLP-1) are dramatically increased after GB, suggesting that its action contributes to alteration in postprandial glucose regulation. The aim of this study was to establish the role of GLP-1 on insulin secretion in patients with GB. RESEARCH DESIGN AND METHODS: Twelve asymptomatic individuals with previous GB (Asym-GB), 10 matched healthy nonoperated control subjects, and 12 patients with recurrent hypoglycemia after GB (Hypo-GB) had pre- and postprandial hormone levels and insulin secretion rates (ISR) measured during a hyperglycemic clamp with either GLP-1 receptor blockade with exendin-(9-39) or saline. RESULTS: Blocking the action of GLP-1 suppressed postprandial ISR to a larger extent in Asym-GB individuals versus control subjects (33 ± 4 vs.16 ± 5%; P = 0.04). In Hypo-GB patients, GLP-1 accounted for 43 ± 4% of postprandial ISR, which was not significantly higher than that in Asym-GB subjects (P = 0.20). Glucagon was suppressed similarly by hyperglycemia in all groups but rose significantly after the meal in surgical individuals but remained suppressed in nonsurgical subjects. GLP-1 receptor blockade increased postprandial glucagon in both surgical groups. CONCLUSIONS: Increased GLP-1-stimulated insulin secretion contributes significantly to hyperinsulinism in GB subjects. However, the exaggerated effect of GLP-1 on postprandial insulin secretion in surgical subjects is not significantly different in those with and without recurrent hypoglycemia. |
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Authors:
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Marzieh Salehi; Ronald L Prigeon; David A D'Alessio |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diabetes Volume: 60 ISSN: 1939-327X ISO Abbreviation: Diabetes Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-08-26 Completed Date: 2011-10-31 Revised Date: 2012-05-15 |
Medline Journal Info:
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Nlm Unique ID: 0372763 Medline TA: Diabetes Country: United States |
Other Details:
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Languages: eng Pagination: 2308-14 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Division of Endocrinology, University of Cincinnati, Cincinnati, Ohio, USA. salehim@uc.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Glucose Female Gastric Bypass* Glucagon / blood Glucagon-Like Peptide 1 / blood, pharmacology* Humans Insulin / blood, secretion* Male Middle Aged Pancreas / drug effects, secretion* Postprandial Period / physiology* |
| Grant Support | |
ID/Acronym/Agency:
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DK083554/DK/NIDDK NIH HHS; DK57900/DK/NIDDK NIH HHS; R01 DK057900/DK/NIDDK NIH HHS; UL1RR026314/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Insulin; 89750-14-1/Glucagon-Like Peptide 1; 9007-92-5/Glucagon |
| Comments/Corrections | |
Comment In:
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Diabetes. 2011 Sep;60(9):2203-5
[PMID:
21868790
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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