Introduction
Methods
Recruitment
Preoperative Clinical and Biochemical Information
Measurement of Glucose, Insulin, C-Peptide and Estimation/Calculation of Insulin Sensitivity and β Cell Function
Measurement of Total GLP-1 and Total GIP
Statistical Analysis
Results
Participant Characteristics
Measurement | Preoperative | 1 month | P value* | 6 months | P value† |
---|---|---|---|---|---|
Weight (kg) | 146.4 [129–171] | 129.8 [107–144] | < 0.001 | 114.2 [102–124] | < 0.001 |
BMI (kg/m2) | 50.5 [45.0–54.0] | 44.4 [38.0–49.2] | < 0.001 | 38.2 [34.1–41.9] | < 0.001 |
Waist (cm) | 140 [127–152] | 124 [114–142] | < 0.001 | 116 [107–128] | < 0.001 |
Systolic BP (mmHg) | 126 [115–134] | 120 [111–133] | 0.044 | 120 [112–136] | 0.117 |
Diastolic BP (mmHg) | 74 [68–83] | 75 [67–79] | 0.097 | 75 [65–79] | 0.053 |
Cholesterol (mmol/L) | 4.3 [3.5–5.0] | 4.0 [3.3–4.9] | 0.820 | 4.3 [3.8–5.2] | 0.124 |
LDL (mmol/L) | 2.2 [1.8–2.9] | 2.2 [1.7–3.1] | 0.237 | 2.6 [2.0–3.3] | 0.027 |
HDL (mmol/L) | 1.1 [0.9–1.3] | 1.0 [0.9–1.2] | 0.002 | 1.2 [1.0–1.4] | < 0.001 |
Triglyceride (mmol/L) | 1.5 [1.1–2.4] | 1.4 [1.1–1.9] | 0.102 | 1.2 [0.9–1.6] | 0.002 |
Static and Dynamic Changes in Glucose-Insulin Homeostasis Following SG
Measurement | Preoperative | 1 month | P value* | 6 months | P value† |
---|---|---|---|---|---|
A1C (mmol/mol) | 57.0 [46.0–89.3] | 46.0 [38.5–56.0] | < 0.001 | 40.0 [36.0–49.0] | < 0.001 |
A1C (%) | 7.4 [6.4–10.3] | 6.3 [5.6–7.3] | < 0.001 | 5.8 [5.4–6.6] | < 0.001 |
Fasting glucose (mmol/L) | 7.1 [5.9–11.7] | 5.6 [4.6–6.8] | < 0.001 | 5.2 [4.5–5.8] | < 0.001 |
2-h glucose (mmol/L) | 13.4 [9.2–18.4] | 8.8 [5.2–12.7] | < 0.001 | 5.8 [4.2–9.4] | < 0.001 |
Fasting insulin (mU/L) | 21.8 [13.7–29.5] | 12.0 [8.9–19.3] | < 0.001 | 9.0 [5.4–14.1] | < 0.001 |
2-h insulin (mU/L) | 52.8 [27.4–102.4] | 47.1 [27.7–122.6] | 0.210 | 29.7 [16.2–56.9] | 0.010 |
Fasting C-peptide (pmol/mL) | 4.0 [3.5–5.2] | 3.6 [2.7–4.8] | 0.002 | 2.8 [2.0–3.9] | < 0.001 |
2-h C-peptide (pmol/mL) | 8.7 [6.5–11.2] | 10.0 [7.7–12.5] | 0.058 | 8.7 [5.9–11.5] | 0.868 |
HOMA-IR | 3.1 [1.9–4.1] | 1.6 [1.2–2.6] | < 0.001 | 1.3 [0.8–1.9] | < 0.001 |
HOMA-%B | 90.1 [36.2–131.6] | 110.0 [73.0–147.0] | 0.343 | 99.5 [81.0–150.2] | 0.288 |
HOMA-%S | 32.4 [24.5–52.3] | 62.3 [39.0–81.7] | < 0.001 | 75.5 [52.3–121.0] | < 0.001 |
Preoperative | 1 month | P value* | 6 months | P value† | |
---|---|---|---|---|---|
Early Phase (ΔI0–30/ΔG0–30) | 5.3 [1.8–13.0] | 10.0 [5.9–16.3] | 0.172 | 11.9 [5.9–17.4] | < 0.01 |
Late Phase (ΔI60–120/ΔG60–120) | 3.6 [−0.5–12.4] | 13.5 [5.0–21.3] | 0.157 | 11.6 [4.8–21.3] | < 0.01 |
AUC0–30 | |||||
Glucose (mmol h L−1) | 4.6 [3.7–7.0] | 4.2 [3.6–5.1] | 0.154 | 4.0 [3.4–4.4] | < 0.001 |
Insulin (mU h L−1) | 16.6 [10.0–25.4] | 23.0 [13.7–33.7] | 0.002 | 17.5 [14.4–30.1] | 0.005 |
C-peptide (pmol h mL−1) | 2.5 [1.9–3.1] | 3.0 [2.5–3.7] | < 0.001 | 2.4 [2.0–3.4] | 0.020 |
AUC0–60 | |||||
Glucose (mmol h L−1) | 11.3 [9.1–17.0] | 10.2 [8.7–12.6] | 0.066 | 9.0 [7.7–11.8] | < 0.001 |
Insulin (mU h L−1) | 46.9 [27.8–74.3] | 69.8 [42.8–92.5] | 0.001 | 61.0 [37.6–90.7] | 0.005 |
C-peptide (pmol h mL−1) | 6.1 [4.6–7.8] | 7.5 [6.6–9.6] | < 0.001 | 6.5 [5.3–9.0] | < 0.001 |
AUC0–120 | |||||
Glucose (mmol h L−1) | 24.3 [19.1–36.4] | 19.8 [17.3–25.7] | 0.002 | 17.3 [14.6–24.9] | < 0.001 |
Insulin (mU h L−1) | 99.6 [60.1–197.8] | 154.9 [99.8–202.9] | 0.029 | 117.6 [75.6–204.9] | 0.129 |
C-peptide (pmol h mL−1) | 13.9 [11.1–18.8] | 18.5 [15.5–22.9] | < 0.001 | 15.9 [12.2–20.6] | 0.001 |
Static and Dynamic Changes in Incretin Hormone Response Following SG
Measurement | Preoperative | 1 month | P value* | 6 months | P value† |
---|---|---|---|---|---|
Fasting GLP-1 (pmol/L) | 1.77 [1.1–4.2] | 1.70 [0.4–5.2] | 0.354 | 1.13 [0.6–4.5] | 0.195 |
2-h GLP-1 (pmol/L) | 1.49 [0.8–3.8] | 3.91 [1.3–6.7] | 0.067 | 2.48 [1.3–7.0] | 0.060 |
Fasting GIP (pg/mL) | 69.2 [48.0–123.3] | 60.8 [40.9–86.8] | 0.583 | 58.8 [35.1–87.0] | 0.555 |
2-h GIP (pg/mL) | 215.8 [156.7–348.7] | 196.1 [127.2–276.6] | 0.990 | 206.0 [125.6–281.4] | 0.377 |
AUC0–30 | |||||
GLP-1 (pmol h L−1) | 1.5 [0.9–2.7] | 4.2 [2.3–5.9] | < 0.001 | 3.6 [2.1–7.0] | < 0.001 |
GIP (pg h mL−1) | 163.3 [105.5–245.3] | 154.0 [126.2–250.5] | 0.013 | 150.2 [118.8–237.5] | 0.272 |
AUC0–60 | |||||
GLP-1 (pmol h L−1) | 3.2 [1.9–5.9] | 9.6 [5.3–13.9] | < 0.001 | 8.2 [4.2–13.6] | < 0.001 |
GIP (pg h mL−1) | 363.8 [252.4–550.3] | 362.6 [282.7–610.4] | 0.010 | 363.1 [273.5–582.2] | 0.214 |
AUC0–120 | |||||
GLP-1 (pmol h L−1) | 5.1 [3.2–10.6] | 14.8 [8.8–24.7] | < 0.001 | 13.5 [6.4–22.3] | < 0.001 |
GIP (pg h mL−1) | 710.2 [499.5–1043.5] | 685.5 [525.3–1092.1] | 0.049 | 711.6 [508.3–998.0] | 0.717 |