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Type: Artigo de periódico
Title: Acute Effect Of Roux-en-y Gastric Bypass On Whole-body Insulin Sensitivity: A Study With The Euglycemic-hyperinsulinemic Clamp.
Author: Lima, Marcelo M O
Pareja, José C
Alegre, Sarah M
Geloneze, Sylka R
Kahn, Steven E
Astiarraga, Brenno D
Chaim, Elinton A
Geloneze, Bruno
Abstract: Insulin resistance ameliorates after bariatric surgery, yet there is still a need for data on the acute effect of Roux-en-Y gastric bypass (RYGBP) on insulin sensitivity. The objective of the study was to describe the acute effect of RYGBP on insulin sensitivity, measured by both the euglycemic-hyperinsulinemic clamp and homeostasis model assessment insulin resistance index (HOMA-IR). Evaluations were conducted before and 1 month after RYGBP at State University of Campinas (São Paulo, Brazil). Patients included 19 premenopausal women with metabolic syndrome aged 35.3 (6.7) yr, body mass index 45.50 (3.74) kg/m2 [mean (sd)]. Six had mild type 2 diabetes, seven impaired glucose tolerance, and six normal glucose tolerance. The volunteers underwent RYGBP either alone or combined with omentectomy. Euglycemic-hyperinsulinemic clamp, HOMA-IR, nonesterified fatty acids, leptin, ultrasensitive C-reactive protein, adiponectin, and IL-6 were assessed at baseline and 4.5 (0.9) wk postoperatively. Fasting glucose decreased [99.2 (13.1) to 83.6 (8.1) mg/dl, P<0.01] along with a reduction in fasting insulin [30.4 (17.0) to 11.4 (6.3) mU/liter, P<0.01]. M value did not improve postoperatively [25.82 (6.30) to 22.02 (6.05) micromol/kgFFM.min] despite of a decrease in body weight [114.8 (14.5) to 102.3 (14.5) kg, P<0.001]. This finding was discordant to the observation of an improvement in HOMA-IR [3.85 (2.10) to 1.42 (0.76), P<0.01]. Nonesterified fatty acids increased. Leptin and C-reactive protein decreased. IL-6 and adiponectin remained unchanged. A month after RYGBP, fasting glucose metabolism improves independent of a change in peripheral insulin sensitivity.
Subject: Adiponectin
Blood Glucose
Body Mass Index
C-reactive Protein
Diabetes Mellitus, Type 2
Enzyme-linked Immunosorbent Assay
Fatty Acids, Nonesterified
Gastric Bypass
Glucose Clamp Technique
Insulin Resistance
Metabolic Syndrome X
Obesity, Morbid
Statistics, Nonparametric
Treatment Outcome
Citation: The Journal Of Clinical Endocrinology And Metabolism. v. 95, n. 8, p. 3871-5, 2010-Aug.
Rights: fechado
Identifier DOI: 10.1210/jc.2010-0085
Date Issue: 2010
Appears in Collections:Unicamp - Artigos e Outros Documentos

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