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Erschienen in: Obesity Surgery 9/2017

27.04.2017 | Original Contributions

Predictive Value of Gut Peptides in T2D Remission: Randomized Controlled Trial Comparing Metabolic Gastric Bypass, Sleeve Gastrectomy and Greater Curvature Plication

verfasst von: Anna Casajoana, Jordi Pujol, Amador Garcia, Jordi Elvira, Nuria Virgili, Francisco Javier de Oca, Xavier Duran, Sonia Fernández-Veledo, Joan Vendrell, Nuria Vilarrasa

Erschienen in: Obesity Surgery | Ausgabe 9/2017

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Abstract

Background

Our aim was to determine the predictive value of gut hormone changes for the improvement of type 2 diabetes (T2D) following metabolic Roux-en-Y gastric bypass (mRYGB), sleeve gastrectomy (SG), and greater curvature plication (GCP) in a randomized controlled trial.

Summary Background Data

Contradictory results have been obtained regarding the role of gastrointestinal hormones (in particular GLP-1) in beneficial metabolic bariatric surgery outcomes.

Methods

Forty-five patients with T2D (mean BMI 39.4 ± 1.9 kg/m2) were randomly assigned to mRYGB, SG, or GCP. Anthropometric and biochemical parameters, fasting concentrations of PYY, ghrelin, glucagon, and area under the curve (AUC) of GLP-1 after a standard meal test were determined prior to and at months 1 and 12 after surgery.

Results

Twelve months after surgery, total weight loss percentage was higher and HbA1c lower in the mRYGB group than in the SG and GCP groups (−35.2 ± 8.1 and 5.1 ± 0.6% vs. −27.8 ± 5.4 and 6.2 ± 0.8% vs. −20.5 ± 6.8 and 6.6 ± 1.3%; p = 0.007 and p < 0.001, respectively). Moreover, GLP-1 AUC at months 1 and 12 was greater and T2D remission was higher in mRYGB (80 vs. 53.3 vs. 20%, p < 0.001). Insulin treatment (odds ratio (OR) 0.025, p = 0.018) and the increase in GLP-1 AUC from baseline to month 1 (OR 1.021, p = 0.013) were associated with T2D remission.

Conclusions

mRYGB achieves a superior rate of weight loss and T2D remission at month 12. Enhanced GLP-1 secretion 1 month after surgery was a determinant of glucose metabolism improvement. Registration number (http://​www.​clinicaltrials.​gov): NCT14104758.
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Zurück zum Zitat Lee W-J, Almulaifi A, Tsou JJ,et al. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score. Surg Obes Relat Dis. 2015;11(5):991–6. Lee W-J, Almulaifi A, Tsou JJ,et al. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score. Surg Obes Relat Dis. 2015;11(5):991–6.
Metadaten
Titel
Predictive Value of Gut Peptides in T2D Remission: Randomized Controlled Trial Comparing Metabolic Gastric Bypass, Sleeve Gastrectomy and Greater Curvature Plication
verfasst von
Anna Casajoana
Jordi Pujol
Amador Garcia
Jordi Elvira
Nuria Virgili
Francisco Javier de Oca
Xavier Duran
Sonia Fernández-Veledo
Joan Vendrell
Nuria Vilarrasa
Publikationsdatum
27.04.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 9/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2669-7

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