Change in insulin resistance, beta cell function, glucagon-like peptide-1 and calcitonin levels two weeks after bariatric surgery

Sridharan, Kalyani; Kalayarasan, Raja; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Kar, Sitanshu Sekhar; Nandhini, Lakshmana Perumal; Palui, Rajan; Durgia, Harsh

doi:10.1016/j.dsx.2019.05.002

Cited by 11 publications

(5 citation statements)

References 24 publications

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“…RYGB and SG surgery also significantly improved alanine aminotransferase, aspartate aminotransferase, NAFLD activity score and NAFLD fibrosis score [37]. Hepatic insulin resistance was markedly decreased post-surgery, while beta cell function improved due to an increase in postprandial GLP-1 level [40,41]. In a study by Feng et al fasting insulin and 120 min insulin decreased significantly in post-RYGB patients.…”

Section: Impact Of Gastric Bypass Surgery On Gut Microbiotamentioning

confidence: 87%

Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

2020

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Bariatric surgery leads to sustained weight loss and the resolution of obesity-related comorbidities. Recent studies have suggested that changes in gut microbiota are associated with the weight loss induced by bariatric surgery. Several studies have observed major changes in the microbial composition following gastric bypass surgery. However, there are inconsistencies between the reported alterations in microbial compositions in different studies. Furthermore, it is well established that diet is an important factor shaping the composition and function of intestinal microbiota. However, most studies on gastric bypass have not assessed the impact of dietary intake on the microbiome composition in general, let alone the impact of restrictive diets prior to bariatric surgery, which are recommended for reducing liver fat content and size. Thus, the relative impact of bariatric surgery on weight loss and gut microbiota remains unclear. Therefore, this review aims to provide a deeper understanding of the current knowledge of the changes in intestinal microbiota induced by bariatric surgery considering pre-surgical nutritional changes.

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Section: Impact Of Gastric Bypass Surgery On Gut Microbiotamentioning

confidence: 87%

Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

2020

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“…This is interesting because obesity surgery is known to improve glucose homeostasis before significant weight loss ensues [ 32 , 33 ] and this also occurs with calorie restriction [ 34 ]. The mechanisms by which pancreatic cell health and function are improved remain unknown [ 35 ] though it has been suggested that gut hormones, especially glucagon-like peptide-1 [ 36 ], may modulate this effect. Better understanding of what happens in the aftermath of obesity surgery will provide novel insights into our understanding of the management of chronic metabolic sequalae of obesity, especially T2D.…”

Section: Discussionmentioning

confidence: 99%

The impact of prior obesity surgery on glucose metabolism after body contouring surgery: A pilot study

et al. 2023

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Body contouring surgery enhances physical appearance by means of surgical subcutaneous fat removal (SSFR). However, it remains unclear how SSFR may affect glucose metabolism and its broader effects on the endocrine system, especially in individuals who have undergone obesity (bariatric) surgery. This study aimed to evaluate the impact of SSFR on glucose excursion and insulin resistance in such patients, by examining them over three visits (within 1 week before surgery, 1 week after surgery and 6 weeks after surgery). The independent impact of SSFR and history of obesity surgery on glucose homeostasis was evaluated in twenty-nine participants, of whom ten patients (34%) had a history of obesity surgery. Indices of glucose metabolism were evaluated using cluster robust-error logistic regression. Results indicated that SSFR led to a gross improvement in insulin resistance at 6-weeks after the surgery in all patient’s irrespective of BMI, type 2 diabetes mellitus (T2D) status or history of obesity surgery (OR 0.22; P=0.042). However, no effect was observed on glucose excursion except for a transient increase at visit 2 (1 week after surgery) in those without prior obesity surgery. Interestingly, participants with a history of obesity surgery had approximately half the odds being in the upper tertile for HOMA-IR (OR 0.44; p=0.142) and ten-folds lower odds of having severely abnormal glucose excursion (OR 0.09; p=0.031), irrespective of their BMI, T2D status, or time post SSFR. In conclusion, this study showed that body contouring surgery through SSFR resulted in (at least) short-term improvement in insulin resistance (independent of the participant’s BMI, T2D status or history of obesity surgery) without affecting glucose excursion under the GTT. On the contrary, obesity surgery may have a long-term effect on glucose excursion, possibly due to sustained improvement of pancreatic β-cell function.

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“…Given such improved glycemic homeostasis, LSG should be considered early in the prevention and treatment of these two conditions in adolescence, especially for those who fail medical therapy [42]. Such improvements after bariatric surgery could be due to the decrease in insulin resistance, increase in postprandial GLP-1 levels, and enhanced beta cell function [43,44]. Equally, our sample had substantial and durable remission of elevated liver enzymes, supporting others who reported 100% and 95.8% AST and ALT resolution 5 years after RYGB [11].…”

Section: Discussionmentioning

confidence: 99%

Durability of Cardiometabolic Outcomes Among Adolescents After Sleeve Gastrectomy: First Study with 9-Year Follow-up

Ansari

2021

OBES SURG

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Background Long-term durability of weight loss and comorbidity resolution beyond 7 years after laparoscopic sleeve gastrectomy (LSG) among adolescents is completely lacking. Methods Retrospective review of adolescents aged ≤ 18 years who underwent primary LSG at our institution between 2011 and 2015 (N = 146). We assessed anthropometric and cardiometabolic outcomes at 1, 3, 5, 7, and 9 years. Results Follow-up rates were 57.53%, 82.87%, 85.24%, 83.92%, and 83.33% at the five time points. The preoperative mean body mass index (BMI) (45.60 ± 6.50 kg/m2) decreased at year 1 (30.04 ± 4.96 kg/m2, P=0.001) and was maintained up to 9 years (30.20 ± 3.92 kg/m2, P = 0.001). Remission rates were triglycerides, 100% (11/11) at 5 years, and 100% (1/1) at 9 years; high density lipoprotein, 89.4% (17/19) at 5 years, and 100% (3/3) at 7 years; low density lipoprotein, 71.4% (11/14) and 100% (3/3) at 5 and 7 years; total cholesterol, 70% (7/10) at 5 years, and 100% (2/2) at 9 years; uric acid, 100% (3/3) at 5 years. Remission of liver enzymes was 84.6–100% (22/26–2/2) at 5–9 years. Prediabetes remission was 87.5% (14/16 and 7/8) at 5 and 7 years and 100% (3/3) at year 9. Type 2 diabetes complete remission was 50% (3/6, 1/2) at years 5 and 7, with all cases resolved at 9 years. The only case of hypertension completely resolved. Conclusions LSG achieved substantial weight loss and remission of cardiometabolic risk factors that were sustained on the long term. This is the first study among adolescents to assess such outcomes beyond 7 years. Graphical abstract

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Change in insulin resistance, beta cell function, glucagon-like peptide-1 and calcitonin levels two weeks after bariatric surgery

Cited by 11 publications

References 24 publications

Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

Microbial Adaptation Due to Gastric Bypass Surgery: The Nutritional Impact

The impact of prior obesity surgery on glucose metabolism after body contouring surgery: A pilot study

Durability of Cardiometabolic Outcomes Among Adolescents After Sleeve Gastrectomy: First Study with 9-Year Follow-up

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