Department of Internal Medicine, School of Medical Sciences, PO, University of Campinas-UNICAMP, Campinas, SP, 13083-970, Brazil.
Department of Internal Medicine, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil.
Langenbecks Arch Surg. 2022 Mar;407(2):559-568. doi: 10.1007/s00423-021-02341-3. Epub 2021 Oct 14.
Glucagon-like peptide-1 (GLP-1) is a hormone widely studied in the short-term postoperative follow-up of Roux-en-Y gastric bypass due to its elevation and association with improvement of the glucose metabolism, but there are few studies in 10 years after RYGB follow-up with the same patient.
Twenty morbidity obesity patients were submitted to RYGB; these patients were divided into two groups: normal glucose-tolerant morbidly obese patients (NGT) 11 patients and abnormal glucose metabolism morbidly obese patients (AGM) 9 patients. Oral glucose tolerance test (OGTT) was done during four different periods: T1 (first evaluation), T2 (pre-surgery), T3 (9 months after surgery) and T4 (10 years after surgery).
Groups were matched for age and gender, and as NGT and AGM had BMI of 46.31 ± 5.03 kg/m and 50.87 ± 10.31 kg/m After 10 years of RYGB, they were obesity grade I with BMI for NGT 32.45 ± 4.99 kg/m and AGM 34.85 ± 4.46 kg/m. Plasma glucose levels decreased NGT group at T4 period had a significant reduction at 120 min after OGTT for NGT 55.49 ± 17.15 mg/dL (p˂0.001). Insulin levels changed from T1 to T4 for the NGT group. GLP-1 curves were statistically different between the NGT and AGM groups. The AGM group had a higher mean for GLP-1 secretion at T4 period and at 30 min of OGTT 63.85 ± 37.98 pmol/L when compared to NGT 50.73 ± 24.82 pmol/L with AGM > NGT with p˂0.001.
Evaluation of the same patient during 4 different periods shows that, even with weight regain, after 10-years of RYGB high levels of GLP-1 remained which can be associated with metabolic improvement especially at the NGT group.
胰高血糖素样肽-1（GLP-1）是一种在 Roux-en-Y 胃旁路术后短期随访中广泛研究的激素，因为它的升高与改善葡萄糖代谢有关，但在 RYGB 术后 10 年对同一名患者进行同样的随访研究较少。
20 名病态肥胖患者接受了 RYGB；这些患者被分为两组：正常糖耐量病态肥胖患者（NGT）11 例和异常葡萄糖代谢病态肥胖患者（AGM）9 例。在四个不同时期进行口服葡萄糖耐量试验（OGTT）：T1（首次评估）、T2（术前）、T3（术后 9 个月）和 T4（术后 10 年）。
两组在年龄和性别上相匹配，NGT 和 AGM 的 BMI 分别为 46.31±5.03kg/m 和 50.87±10.31kg/m。RYGB 术后 10 年，他们的肥胖程度为 I 级，NGT 的 BMI 为 32.45±4.99kg/m，AGM 的 BMI 为 34.85±4.46kg/m。血糖水平下降，NGT 组在 T4 期 OGTT 120 分钟后血糖显著降低，为 55.49±17.15mg/dL（p˂0.001）。胰岛素水平从 T1 期到 T4 期发生变化。NGT 组的 GLP-1 曲线在统计学上有差异。AGM 组在 T4 期和 OGTT 30 分钟时的 GLP-1 分泌均值较高，分别为 63.85±37.98pmol/L，而 NGT 组为 50.73±24.82pmol/L，AGM>NGT，p˂0.001。
对同一名患者在四个不同时期进行评估表明，即使体重有恢复，在 RYGB 术后 10 年，仍存在高水平的 GLP-1，这可能与代谢改善有关，尤其是在 NGT 组。
