Gilijamse Pim W, Demirkiran Ahmet, van Wagensveld Bart A, Ackermans Mariette T, Romijn Johannes A, Nieuwdorp Max, Ter Horst Kasper W, Serlie Mireille J
Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands.
Surg Obes Relat Dis. 2021 Aug;17(8):1440-1448. doi: 10.1016/j.soard.2021.04.022. Epub 2021 May 24.
Glucagon-like peptide-1 (GLP-1) receptor agonist treatment is beneficial for the human glucose metabolism, and GLP-1 secretion is greatly enhanced following Roux-en-Y gastric bypass (RYGB).
To elucidate the relationship between GLP-1 concentrations and insulin sensitivity in subjects with class II/III obesity without diabetes and to assess the relation between GLP-1 and the improvements in glucose metabolism following RYGB.
Clinical research facility in a university hospital.
We recruited 35 patients scheduled for RYGB and assessed their plasma GLP-1, insulin, and glucose responses to a high-fat mixed meal. Basal and insulin-mediated glucose fluxes were determined during a 2-step hyperinsulinemic-euglycemic clamp with stable isotope-labeled tracers. Out of 35 subjects, 10 were studied both before surgery and at 1 year of follow-up.
Plasma GLP-1 increased following the high-fat mixed meal. Postprandial GLP-1 excursions correlated positively with hepatic and peripheral insulin sensitivity, but not with body mass index. At 1 year after RYGB, participants had lost 24% ± 6% of their body weight. Plasma GLP-1, insulin, and glucose levels peaked earlier and higher after the mixed meal. The positive association between the postprandial GLP-1 response and peripheral insulin sensitivity persisted.
Postprandial GLP-1 concentrations correlate with insulin sensitivity in subjects with class II/III obesity without diabetes before and 1 year after RYGB. Increased GLP-1 signaling in postbariatric patients may, directly or indirectly, contribute to the observed improvements in insulin sensitivity and metabolic health.
胰高血糖素样肽-1（GLP-1）受体激动剂治疗对人体葡萄糖代谢有益，且在 Roux-en-Y 胃旁路术（RYGB）后 GLP-1 的分泌会大幅增加。
阐明无糖尿病的 II/III 级肥胖受试者中 GLP-1 浓度与胰岛素敏感性之间的关系，并评估 GLP-1 与 RYGB 后葡萄糖代谢改善之间的关系。
大学医院的临床研究机构。
我们招募了 35 名计划接受 RYGB 的患者，并评估了他们对高脂混合餐的血浆 GLP-1、胰岛素和葡萄糖反应。在使用稳定同位素标记示踪剂的两步高胰岛素-正常血糖钳夹过程中测定基础和胰岛素介导的葡萄糖通量。在 35 名受试者中，10 名在手术前和随访 1 年时均接受了研究。
高脂混合餐后血浆 GLP-1 升高。餐后 GLP-1 波动与肝脏和外周胰岛素敏感性呈正相关，但与体重指数无关。RYGB 术后 1 年，参与者体重减轻了 24%±6%。混合餐后血浆 GLP-1、胰岛素和葡萄糖水平达到峰值的时间更早且更高。餐后 GLP-1 反应与外周胰岛素敏感性之间的正相关关系持续存在。
在无糖尿病的 II/III 级肥胖受试者中，术前及 RYGB 术后 1 年，餐后 GLP-1 浓度与胰岛素敏感性相关。减重术后患者 GLP-1 信号增强可能直接或间接导致观察到的胰岛素敏感性改善和代谢健康改善。
