http://www.cnr.it/ontology/cnr/individuo/prodotto/ID277098

Roux-en-Y gastric bypass and sleeve gastrectomy: mechanisms of diabetes remission and role of gut hormones (Articolo in rivista)

Type

Articolo in rivista (Classe)
Prodotto della ricerca (Classe)

Label

Roux-en-Y gastric bypass and sleeve gastrectomy: mechanisms of diabetes remission and role of gut hormones (Articolo in rivista) (literal)

Anno

2013-01-01T00:00:00+01:00 (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi

10.1210/jc.2013-2538 (literal)

Alternative label

Nannipieri, M.;Baldi, S.;Mari, A.;Colligiani, D.;Guarino, D.;Camastra, S.;Barsotti, E.;Berta, R.;Moriconi, D.;Bellini, R.;Anselmino, M.;Ferrannini, E. (2013)
Roux-en-Y gastric bypass and sleeve gastrectomy: mechanisms of diabetes remission and role of gut hormones
in The Journal of clinical endocrinology and metabolism
(literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori

Nannipieri, M.;Baldi, S.;Mari, A.;Colligiani, D.;Guarino, D.;Camastra, S.;Barsotti, E.;Berta, R.;Moriconi, D.;Bellini, R.;Anselmino, M.;Ferrannini, E. (literal)

Pagina inizio

4391 (literal)

Pagina fine

9 (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#url

http://www.ncbi.nlm.nih.gov/pubmed/24057293 (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume

98 (literal)

Rivista

?The ?Journal of clinical endocrinology and metabolism (Rivista)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroFascicolo

11 (literal)

Note

ISI Web of Science (WOS) (literal)
Scopu (literal)

Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#affiliazioni

1-2, 4-10, 12: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy; 3: Consiglio Nazionale Delle Ricerche Institute of Biomedical Engineering, 35137 Padua, Italy; 11: Division of Bariatric Surgery, Azienda Ospedaliera Universitaria Pisana, 56124 Pisa, Italy; (literal)

Titolo

Roux-en-Y gastric bypass and sleeve gastrectomy: mechanisms of diabetes remission and role of gut hormones (literal)

Abstract

Context: In obese patients with type 2 diabetes (T2DM), Roux-en-Y-gastric-bypass (RYGB) and sleeve gastrectomy (SLG) improve glycemic control. Objective: The objective of this study was to investigate the mechanisms of surgery-induced T2DM improvement and role of gastrointestinal hormones. Patients, Setting, and Intervention: In 35 patients with T2DM, we performed a mixed-meal test before and 15 days and 1 year after surgery (23 RYGB and 12 SLG). Main Outcome Measures: Insulin sensitivity, beta-cell function, and amylin, ghrelin, PYY, pancreatic polypeptide (PP), glucagon, and glucagon-like peptide-1 (GLP-1) responses to the meal were measured. Results: T2DM remission occurred in 13 patients undergoing RYGB and in 7 patients undergoing SLG. Similarly in the RYGB and SLG groups, beta-cell glucose sensitivity improved both early and long term (P < .005), whereas insulin sensitivity improved long term only (P < .006), in proportion to body mass index changes (P < .001). Early after RYGB, glucagon and GLP-1 responses to the meal increased, whereas the PP response decreased. At 1 year, PYY was increased, and PP, amylin, ghrelin, and GLP-1 were reduced. After SLG, hormonal responses were similar to those with RYGB except that PP was increased, whereas amylin was unchanged. In remitters, fasting GLP-1 was higher (P = .04), but its meal response was flat compared with that of nonremitters; postsurgery, however, the GLP-1 response was higher. Other hormone responses were similar between the 2 groups. In logistic regression, presurgery beta-cell glucose sensitivity (positive, P < .0001) and meal-stimulated GLP-1 response (negative, P = .004) were the only predictors of remission. Conclusions: RYGB and SLG have a similar impact on diabetes remission, of which baseline beta-cell glucose sensitivity and a restored GLP-1 response are the chief determinants. Other hormonal responses are the consequences of the altered gastrointestinal anatomy. (literal)

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