Sanderson I, Deitel M, Bojm M A
JPEN J Parenter Enteral Nutr. 1983 May-Jun;7(3):274-6. doi: 10.1177/0148607183007003274.
Glucose and insulin response were studied in morbidly obese patients before and after jejuno-ileal bypass. Postbypass studies were performed after weight loss greater than 30% (9-48 mon). Six-hour oral glucose tolerance tests were performed on 33 patients before bypass and on 13 of these 33 patients after bypass. Thirteen patients had preoperative intravenous glucose tolerance tests performed, and 11 had postbypass intravenous glucose tolerance tests performed. Plasma insulins were drawn concomitantly. Before bypass, fasting blood sugars and insulins were elevated and both glucose intolerance and hyperinsulinemia were found on the tests. After bypass, oral glucose tolerance test curves were flat (malabsorption effect), while intravenous glucose tolerance tests revealed nonsignificant changes in the glucose curves but plasma insulin response returned toward normal (p greater than 0.05). The glucose intolerance and hyperinsulinemia found in these massively obese patients reverted toward normal after weight loss from jejuno-ileal bypass. Thus elevated plasma insulin does not appear to be a primary etiological factor in obesity.
对病态肥胖患者在空肠回肠分流术前后的葡萄糖和胰岛素反应进行了研究。分流术后的研究在体重减轻超过30%（9 - 48个月）后进行。对33例患者在分流术前以及这33例患者中的13例在分流术后进行了6小时口服葡萄糖耐量试验。13例患者进行了术前静脉葡萄糖耐量试验，11例进行了分流术后静脉葡萄糖耐量试验。同时采集血浆胰岛素。分流术前，空腹血糖和胰岛素升高，试验中发现葡萄糖不耐受和高胰岛素血症。分流术后，口服葡萄糖耐量试验曲线变平（吸收不良效应），而静脉葡萄糖耐量试验显示葡萄糖曲线无显著变化，但血浆胰岛素反应恢复正常（p大于0.05）。这些极度肥胖患者中发现的葡萄糖不耐受和高胰岛素血症在空肠回肠分流术后体重减轻后恢复正常。因此，血浆胰岛素升高似乎不是肥胖的主要病因因素。
