Intestinal resection-associated metabolic syndrome

Barron, Lauren; Courtney, Cathleen; Bao, James; Onufer, Emily J.; Panni, Roheena Z.; Aladegbami, Bola; Warner, Brad W.

doi:10.1016/j.jpedsurg.2018.02.077

Cited by 20 publications

(8 citation statements)

References 26 publications

(27 reference statements)

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“…In mouse models of SBS, intestinal resection results in increased total body adiposity and decreased lean muscle mass with evidence of metabolic syndrome [4], [5], [6]. While initial weight loss following resection was reversed and weight returned to baseline, mice with SBS had altered body composition, with preferentially increased body fat stores compared to lean body mass [5].…”

Section: Introductionmentioning

confidence: 99%

Increased Adiposity and Reduced Lean Body Mass in Patients with Short Bowel Syndrome

et al. 2020

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Background: Few studies have examined the metabolic consequences of short bowel syndrome (SBS) and its effects on body composition in adults. We hypothesized that body composition of SBS patients is altered compared to a normal age, race, and sex-matched population, regardless of parenteral nutrition (PN) dependence. Aim:To compare the body composition of adult patients with SBS to age, sex and race matched healthy controls.Methods: Twenty patients with SBS underwent body composition analysis using the GE Lunar iDXA scanner. Patients were age, sex and race matched to controls from the National Health and Nutrition Examination Survey (1999)(2000)(2001)(2002)(2003)(2004). Mean differences in body mass index, fat free mass, fat mass, percent body fat, visceral adipose tissue mass and volume, and bone mineral density were measured. Statistical analysis was performed using SAS 9.4 software.Results: Fifty-five percent of subjects had a history of PN use and 30% were current PN users. Mean percent body fat for SBS patients was 35.1% compared to 30.9% for healthy controls (p=0.043). Fat free mass was reduced in SBS (p=0.007). Patients with reduced bone mass had a Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1

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Section: Introductionmentioning

confidence: 99%

Increased Adiposity and Reduced Lean Body Mass in Patients with Short Bowel Syndrome

et al. 2020

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“…Short bowel syndrome induced in mouse models is associated with increased pancreatic islet size, number, and proliferation (6,7). The upper intestinal hypothesis where glycemic control improves if ingested contents avoid contact with the proximal small intestine, namely the duodenum, has been suggested to have a role, though its exact mechanism is yet to be defined (6).…”

Section: Discussionmentioning

confidence: 99%

“…Perez-Arana et al (6) postulated that the pancreatic islet cell change could reflect a stage of development of nesidioblastosis. However, Barron et al (7) have shown in mouse models following intestinal resection, evidence of metabolic consequences including glucose intolerance, hepatic steatosis, and abnormal body composition with less lean mass (7). Though, the underlying pathophysiology of a paradoxical decrease in b-cell function following short bowel syndrome remains to be defined (7).…”

Section: Discussionmentioning

confidence: 99%

Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 Diabetes

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Conway

Cooper

et al. 2019

AACE Clinical Case Reports

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Objective: Adult nesidioblastosis is characterized by endogenous hyperinsulinemia typically causing post-prandial hypoglycemia, and most commonly occurs post-Roux-en-Y gastric bypass. Methods: We report a unique case of nesidioblastosis occurring in a 67-year-old female. Results: A 5-year history of symptomatic hypoglycemia occurred in a patient with short bowel syndrome and type 2 diabetes mellitus (T2DM) managed previously with a glucagon-like peptide 1 (GLP-1) agonist, which achieved significant weight loss. Continuous glucose monitoring captured 42 hypoglycemia episodes in a 2-week period, and following an oral glucose tolerance test there was the suggestion of a hyperinsulinemia state. She was managed with an open distal pancreatectomy, and subsequently required medical therapy to maintain euglycemia. Conclusion: We present the first case of nesidioblastosis occurring in a patient with short bowel syndrome, pre-existing T2DM managed with a GLP-1 agonist which achieved significant weight loss, all of which we speculate could have predisposed to hypoglycemia and development of nesidioblastosis.

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“…The changes to the microbiome and increased inflammation due to the placement of the DJBL, also seen in humans with an implanted DJBL 41 , make it difficult to equate the DJBL to a nutrientbypass of the first portion of the small intestine that would occur during Roux-en-Y gastric bypass J o u r n a l P r e -p r o o f 14 Running title: Duodenal exclusion in a non-obese canine model or other bariatric procedures with duodenal exclusion. However, it is noteworthy that mice who underwent short bowel resection had increased inflammation and glucose intolerance with no change on insulin sensitivity weeks post-surgery 42 . In addition, a control group with placement of the stent without the liner was not used.…”

Section: Limitationsmentioning

confidence: 98%