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Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function

CONTEXT: Roux-en-Y gastric bypass (RYGB) is associated with postprandial hyperinsulinemia. OBJECTIVE: This study assessed whether increased blood insulin levels may be due to an increase in maximal β-cell function. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional study at Columbia U...

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Autores principales: Georgia, Annette, Asnis, Maria Cecilia Catilo, Febres, Gerardo, Tsang, Amanda, Bessler, Marc, Korner, Judith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Endocrine Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391719/
https://www.ncbi.nlm.nih.gov/pubmed/30834358
http://dx.doi.org/10.1210/js.2018-00213
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author Georgia, Annette
Asnis, Maria Cecilia Catilo
Febres, Gerardo
Tsang, Amanda
Bessler, Marc
Korner, Judith
author_facet Georgia, Annette
Asnis, Maria Cecilia Catilo
Febres, Gerardo
Tsang, Amanda
Bessler, Marc
Korner, Judith
author_sort Georgia, Annette
collection PubMed
description CONTEXT: Roux-en-Y gastric bypass (RYGB) is associated with postprandial hyperinsulinemia. OBJECTIVE: This study assessed whether increased blood insulin levels may be due to an increase in maximal β-cell function. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional study at Columbia University Medical Center, New York, New York. Subjects without a history of diabetes were studied after surgery (n = 12) and were compared with nonsurgical controls (n = 10) who were mean matched for body mass index, insulin sensitivity, and hemoglobin A1c and with nonobese controls (n = 8). METHODS: Subjects underwent a mixed-meal tolerance test and on a separate day an intravenous glucose tolerance test followed by a hyperglycemic clamp (450 mg/dL; 25 mM blood glucose) and arginine stimulation. The main outcome measure was maximal insulin secretion quantified after arginine stimulation (AinsRmax). RESULTS: The RYGB group exhibited greater peak postprandial glucose levels and fourfold greater peak insulin levels than control groups; however, there were no significant differences in insulinogenic index or AinsRmax. Another finding was significantly greater postprandial glucagon levels in the RYGB group compared with controls. CONCLUSIONS: Our results suggest that after RYGB, the increase in postprandial levels of insulin are not due to changes in maximal β-cell function but appear to be an appropriate response to altered nutrient flow and absorption.
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spelling pubmed-63917192019-03-04 Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function Georgia, Annette Asnis, Maria Cecilia Catilo Febres, Gerardo Tsang, Amanda Bessler, Marc Korner, Judith J Endocr Soc Clinical Research Articles CONTEXT: Roux-en-Y gastric bypass (RYGB) is associated with postprandial hyperinsulinemia. OBJECTIVE: This study assessed whether increased blood insulin levels may be due to an increase in maximal β-cell function. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional study at Columbia University Medical Center, New York, New York. Subjects without a history of diabetes were studied after surgery (n = 12) and were compared with nonsurgical controls (n = 10) who were mean matched for body mass index, insulin sensitivity, and hemoglobin A1c and with nonobese controls (n = 8). METHODS: Subjects underwent a mixed-meal tolerance test and on a separate day an intravenous glucose tolerance test followed by a hyperglycemic clamp (450 mg/dL; 25 mM blood glucose) and arginine stimulation. The main outcome measure was maximal insulin secretion quantified after arginine stimulation (AinsRmax). RESULTS: The RYGB group exhibited greater peak postprandial glucose levels and fourfold greater peak insulin levels than control groups; however, there were no significant differences in insulinogenic index or AinsRmax. Another finding was significantly greater postprandial glucagon levels in the RYGB group compared with controls. CONCLUSIONS: Our results suggest that after RYGB, the increase in postprandial levels of insulin are not due to changes in maximal β-cell function but appear to be an appropriate response to altered nutrient flow and absorption. Endocrine Society 2019-01-23 /pmc/articles/PMC6391719/ /pubmed/30834358 http://dx.doi.org/10.1210/js.2018-00213 Text en Copyright © 2019 Endocrine Society https://creativecommons.org/licenses/by-nc-nd/4.0/ This article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND; https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research Articles
Georgia, Annette
Asnis, Maria Cecilia Catilo
Febres, Gerardo
Tsang, Amanda
Bessler, Marc
Korner, Judith
Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function
title Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function
title_full Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function
title_fullStr Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function
title_full_unstemmed Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function
title_short Roux-en-Y Gastric Bypass Is Associated With Hyperinsulinemia But Not Increased Maximal β-Cell Function
title_sort roux-en-y gastric bypass is associated with hyperinsulinemia but not increased maximal β-cell function
topic Clinical Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391719/
https://www.ncbi.nlm.nih.gov/pubmed/30834358
http://dx.doi.org/10.1210/js.2018-00213
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