Changes in insulin sensitivity and secretion after sleeve gastrectomy

Casella, Giovanni; Soricelli, Emanuele; Castagneto-Gissey, Lidia; Redler, Adriano; Basso, Nicola; Mingrone, Geltrude

doi:10.1002/bjs.10039

Cited by 32 publications

(18 citation statements)

References 40 publications

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“…Consistent with our findings, Casella et al demonstrated that SG improved insulin sensitivity (euglycemic hyperinsulinemic clamp technique) and reduced insulin secretion (OGTT) within 12 months after surgery. The significant changes in insulin sensitivity and insulin secretion indices found in our study were not related to weight loss in the first month follow-up, which might be explained by the early postoperative hormonal changes induced by SG (10,27).…”

Section: Discussioncontrasting

confidence: 57%

Long-Term Improvement of Glucose Homeostasis and Body Composition in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Zetu

Popa

Popa³

et al. 2018

Acta Endo (Buc)

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Context. Laparoscopic sleeve gastrectomy (SG) has gained popularity as a metabolic procedure, but its longterm effectiveness for Romanian patients remains unclear. Objectives. To assess the long-term efficacy of SG for Romanian patients and to evaluate the differences between 5 years and 1 year follow-up. Design. A longitudinal, prospective analysis of collected data from 68 patients undergoing SG between 2009 and 2014 was performed. Long-term outcomes at 5 years were analyzed in terms of total weight loss (%TWL), excess weight loss (%EWL), body composition and glucose homeostasis. Subjects and Methods. All patients meeting the standard criteria for SG before inclusion were prospectively enrolled in the study. Of the 68 patients, eight were lost to follow-up, therefore, 60 patients (41.7±12.5 years, baseline body mass index [BMI] 44.6±9.9Kg/m 2) were analyzed. Results. The BMI decreased at 12 months with 30.7% from the preoperative BMI (p<0.001) and subsequently stabilized at 5 years. TWL and EWL were 30.6% and 83.1%, respectively at 1 year, with a slightly increase at 5 years. Therapeutic success rate (%EWL≥50) and diabetes remission rate (Buchwald criteria) were 93.3% and respectively 63.6% at 5 years. Insulin sensitivity index and metabolic clearance rate of glucose increased with 92.5% and 60.1% respectively, in the third month from baseline (p<0.001), while estimated second phase of insulin secretion decreased with 7.9% in the first month postoperatively (p=0.04), remaining stable afterwards. Conclusions. SG was effective in terms of %EWL, body composition and glucose homeostasis improvement for Romanian patients, the outcomes stabilizing after 1 year follow-up.

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Section: Discussioncontrasting

confidence: 57%

Long-Term Improvement of Glucose Homeostasis and Body Composition in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Zetu

Popa

Popa³

et al. 2018

Acta Endo (Buc)

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“…Bariatric surgery can be extremely effective for long-term body weight loss and amelioration of the comorbidities of obesity (5, 7, 12, 14). About 80% of the recipients of surgical weight loss are women of whom approximately half are of child bearing age.…”

Section: Introductionmentioning

confidence: 99%

Rodent vertical sleeve gastrectomy alters maternal immune health and fetoplacental development

et al. 2018

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Bariatric surgery is increasingly employed to improve fertility and reduce obesity related co-morbidities in obese women. Surgical weight loss not only improves the chance of conception but reduces the risk of pregnancy complications including pre-eclampsia, gestational diabetes, and macrosomia. However, bariatric procedures increase the incidence of intrauterine growth restriction (IUGR), fetal demise, thromboembolism and other gestational disorders. Using our rodent model of vertical sleeve gastrectomy (VSG), we tested the hypothesis that VSG in diet-induced, obese dams would cause immune and placental structural abnormalities that may be responsible for fetal demise during pregnancy. VSG dams studied on gestational day (G) 19 had reduced circulating T cell (CD3+ and CD8+) populations compared to lean or obese controls. Further, local interleukin 1 β and interleukin 1 receptor antagonist mRNA were increased in placenta of VSG dams. Placental barrier function was also affected, with increased trans-placental permeability to small molecules, increased matrix metalloproteinase 9 expression, and increased apoptosis in VSG. Furthermore, we identified increased placental mTOR signaling that may contribute to preserving the body weight of the fetuses during gestation. These changes occurred in the absence of a macronutrient deficit or gestational hypertension in the VSG dams. In summary, previous VSG in dams may contribute to fetal demise by affecting maternal immune system activity and compromise placental integrity.

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“…Peterli et al [ 30 ] have found that postprandial plasma insulin is higher in RYGB patients than in SG patients one week postoperatively, but both surgery groups exhibit similar insulin levels at three months. Although there was a correlation between insulin sensitivity and body weight, the major driver of the improvement in insulin sensitivity after SG was GLP-1 secretion [ 31 ]. Changes in GLP-1 are often considered a mechanism for the weight-independent effects of bariatric surgery on glucose homeostasis, which may explain why purely restrictive procedures or nonsurgical weight loss have little effect on glucose control [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Sleeve Gastrectomy on Glucose Metabolism and Glucagon-Like Peptide 1 in Goto-Kakizaki Rats

Wang²,

Bai³

et al. 2018

Journal of Diabetes Research

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Purpose To investigate the effects of sleeve gastrectomy (SG) on glucose metabolism and changes in glucagon-like peptide 1 (GLP-1) in Goto-Kakizaki (GK) rats. Methods GK rats were randomly assigned to one of three groups: SG, SG pair-fed plus sham surgery (PF-sham), and ad libitum-fed no surgery (control). Food intake, body weight, blood glucose, GLP-1 and insulin levels, and GLP-1 expression in the jejunum and ileum were compared. Results The SG rats exhibited lower postoperative food intake, body weight, and fasting glucose than did the control rats (P < 0.05). SG significantly improved glucose and insulin tolerance (P < 0.05). Plasma GLP-1 levels were higher in SG rats than in control or PF-sham rats in the oral glucose tolerance test (OGTT) (P < 0.05). Blood glucose levels expressed as a percentage of baseline were higher in SG rats than in control rats after exendin (9-39) administration (P < 0.05). The levels of GLP-1 expression in the jejunum and ileum were higher in SG rats than in PF-sham and control rats (P < 0.05). Conclusions Improvement of glucose metabolism by SG was associated with increased GLP-1 secretion. SG contributes to an increase in plasma GLP-1 levels via increased GLP-1 expression in the mucosa of the jejunum and/or ileum.

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Changes in insulin sensitivity and secretion after sleeve gastrectomy

Abstract: Sleeve gastrectomy improved insulin sensitivity and reduced insulin secretion within 6 months after surgery. Although there was a correlation between insulin sensitivity and bodyweight, the major driver of the improvement in insulin sensitivity was GLP-1 secretion.

Cited by 32 publications

References 40 publications

Long-Term Improvement of Glucose Homeostasis and Body Composition in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Long-Term Improvement of Glucose Homeostasis and Body Composition in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Rodent vertical sleeve gastrectomy alters maternal immune health and fetoplacental development

The Effects of Sleeve Gastrectomy on Glucose Metabolism and Glucagon-Like Peptide 1 in Goto-Kakizaki Rats

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