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胰高血糖素样肽-1(GLP-1)和葡萄糖依赖性促胰岛素多肽(GIP)可能在胃旁路术后的长期体重变化轨迹中发挥作用。

GLP-1 and GIP may play a role in long-term weight trajectories after gastric bypass.

作者信息

Andrade Sara, Lobato Carolina B, Machado Mariana, Hartmann Bolette, Holst Jens J, Almeida Rui F, Nora Mário, Monteiro Mariana P, Guimarães Marta, Pereira Sofia S

机构信息

Unit for Multidisciplinary Research in Biomedicine (UMIB), School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal.

ITR-Laboratory of Integrative and Translational Research in Population Health, Porto, Portugal.

出版信息

Front Endocrinol (Lausanne). 2025 Jul 4;16:1624001. doi: 10.3389/fendo.2025.1624001. eCollection 2025.

Abstract

INTRODUCTION

Suboptimal clinical responses to metabolic and bariatric surgery include insufficient weight loss (WL), weight regain (WR), and/or comorbidity remission failure or relapse. Gut hormones' role in WR and Type 2 diabetes (T2D) relapse is not fully established. So, our aim was to evaluate the hormone profiles of patients with long-term optimal and suboptimal response after gastric bypass (RYGB).

METHODS

This cross-sectional study included 43 individuals who underwent RYGB surgery over 10 years ago, divided into two groups: 23 participants with no T2D history but different WR trajectories (cohort 1), and 20 with prior T2D diagnosis and optimal WL (cohort 2), with post-RYGB T2D remission (n=10) or relapse (n=10).

RESULTS

Fasting and postprandial glucose, insulin, C-peptide, glucagon, GLP-1 and GIP levels were evaluated during a mixed-meal tolerance test. In cohort 1, fasting glucose, insulin, C-peptide, and glucagon, as well as the postprandial glucose and GIP levels, were significantly positively correlated with %WR. Additionally, postprandial GLP-1 and glucagon levels were negatively correlated with the %WR. In cohort 2, higher postprandial glucose and lower insulin were observed in participants with T2D relapse. No other significant differences were observed.

DISCUSSION

In sum, greater WR was associated with higher levels of postprandial glucose and GIP, along with lower GLP-1 and glucagon excursions. Whether these are cause or consequence of WR remains to be clarified. Additionally, GIP and GLP-1 profile of participants with T2D relapse did not differ from those with T2D remission.

摘要

引言

代谢和减重手术的临床反应欠佳包括体重减轻不足(WL)、体重反弹(WR)和/或合并症缓解失败或复发。肠道激素在体重反弹和2型糖尿病(T2D)复发中的作用尚未完全明确。因此,我们的目的是评估胃旁路手术(RYGB)后长期有最佳和欠佳反应患者的激素谱。

方法

这项横断面研究纳入了43名在10多年前接受RYGB手术的个体,分为两组:23名无T2D病史但有不同体重反弹轨迹的参与者(队列1),以及20名先前诊断为T2D且体重减轻最佳的参与者(队列2),其中有RYGB术后T2D缓解者(n = 10)或复发者(n = 10)。

结果

在混合餐耐量试验期间评估空腹和餐后血糖、胰岛素、C肽、胰高血糖素、GLP - 1和GIP水平。在队列1中,空腹血糖、胰岛素、C肽和胰高血糖素,以及餐后血糖和GIP水平与体重反弹百分比呈显著正相关。此外,餐后GLP - 1和胰高血糖素水平与体重反弹百分比呈负相关。在队列2中,T2D复发的参与者餐后血糖较高,胰岛素较低。未观察到其他显著差异。

讨论

总之,更大程度的体重反弹与更高的餐后血糖和GIP水平以及更低的GLP - 1和胰高血糖素波动有关。这些是体重反弹的原因还是结果仍有待阐明。此外,T2D复发参与者的GIP和GLP - 激素谱与T2D缓解者没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d62c/12271881/fcdf5e7f3fe7/fendo-16-1624001-g001.jpg

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