Schrumpf E, Bergan A, Djøseland O, Fausa O, Flaten O, Skagen D W, Tronier B
Scand J Gastroenterol Suppl. 1985;107:24-31. doi: 10.3109/00365528509099748.
A series of variables involved in glucose handling were monitored before and after gastric bypass operation for morbid obesity. Blood glucose, insulin, C-peptide, gastric inhibitory polypeptide (GIP), pancreatic polypeptide (PP), and gastrin were measured basally and after an oral glucose load. Blood glucose, insulin, C-peptide, and PP were also measured after an intravenous glucose load. Adrenocortical function was evaluated by measuring plasma cortisol and urinary excretion of 17-hydroxy-corticosteroids and 17-ketosteroids. Nine subjects were examined before and 3 and 12 months after operation. Glucose tolerance improved postoperatively concomitant with decreased basal levels of C-peptide and insulin, increased hepatic insulin extraction, and evidence of reduced adrenocortical function. Parallel with reduced insulin resistance, support for an increase in both insulin secretion and removal was obtained postoperatively. It is concluded that the considerable endocrine abnormalities seen in morbid obesity can be normalized after gastric bypass operation and weight reduction.
对患有病态肥胖症的患者在胃旁路手术前后监测了一系列与葡萄糖代谢相关的变量。在基础状态下以及口服葡萄糖负荷后，测量血糖、胰岛素、C肽、胃抑制多肽（GIP）、胰多肽（PP）和胃泌素。在静脉注射葡萄糖负荷后，也测量血糖、胰岛素、C肽和PP。通过测量血浆皮质醇以及17-羟皮质类固醇和17-酮类固醇的尿排泄量来评估肾上腺皮质功能。在手术前以及术后3个月和12个月对9名受试者进行了检查。术后葡萄糖耐量改善，同时C肽和胰岛素的基础水平降低，肝脏胰岛素提取增加，并且有肾上腺皮质功能降低的证据。与胰岛素抵抗降低并行，术后获得了胰岛素分泌和清除均增加的证据。得出的结论是，病态肥胖症中出现的相当多的内分泌异常在胃旁路手术和体重减轻后可以恢复正常。
