Duodenal-jejunal bypass liner implantation provokes rapid XXXX and improved glycemic control, accompanied by elevated fasting ghrelin levels.

@entity1 @entity353 @entity28 @entity6 @entity164 @entity6757 @entity413
BACKGROUND AND STUDY AIMS: Endoscopic implantation of a duodenal-jejunal bypass liner (DJBL) is a novel bariatric technique to induce @entity353 and remission of @entity6 . Placement of the DJBL mimics the bypass component of the Roux-en-Y gastric bypass (RYGB) procedure. In this observational study, we evaluated improvement of glycemic control and @entity353 in the course of the treatment (0-24 weeks after DJBL implantation) and analyzed accompanying gut hormone responses. @entity1 AND METHODS: 12 @entity28 individuals with @entity164 2 @entity6 were selected for DJBL implantation. Body weight, fat mass, and fasting plasma levels of @entity413 , insulin, C-peptide, and glycated hemoglobin (HbA1c), were analyzed at 0, 1, 4 and 24 weeks post-implant. Fasting ghrelin, gastric inhibitory peptide (GIP), and glucagon-like peptide ( @entity6757 ) were determined at 0, 1 and 4 weeks post-implant. RESULTS: Besides significant @entity353 , fat mass, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) index were also significantly decreased after DJBL implantation and a 42% reduction was found in @entity6 medication (P<0.05). The fasting @entity6757 response in the first 4 weeks post-implant was significantly correlated with the fasting insulin and HOMA-IR response. Fasting ghrelin was found to be significantly elevated, in contrast to the decrease in ghrelin that is found after RYGB surgery. CONCLUSIONS: DJBL implantation provoked significant @entity353 , a decrease in fat mass, and an early remission of @entity164 2 @entity6 , comparable to results seen after RYGB surgery. Gut hormone analyses revealed a potential role of fasting @entity6757 in early remission of @entity164 2 @entity6 . Interestingly, the DJBL-induced elevation of ghrelin contradicts the suggested role of reduced ghrelin levels after RYGB in improvement of glycemic control.
