Long-term effects of Roux-en-Y gastric bypass surgery on plasma glucagon-like peptide-1 and islet function in morbidly XXXX subjects.

@entity1 @entity28 @entity6684 @entity413 @entity5445
CONTEXT: An enlarged incretin response after Roux-en-Y gastric bypass (RYGBP) has been proposed to promote excessive beta-cell function and mass. OBJECTIVE: The objective of the study was to determine whether RYGBP is associated with a steadily increased @entity5445 ( @entity5445 ) response and a disruption of the relationship between insulin sensitivity and insulin secretion required to maintain plasma @entity413 in the normal range. DESIGN AND @entity1 : This was a cross-sectional study. Twenty-four @entity1 divided into three groups according to time after RYGBP (9-15, 21-30, and more than 36 months). Eight normal-weight and eight morbidly @entity28 @entity1 served as controls. MAIN OUTCOME MEASURES: @entity5445 was determined after a standardized test meal. Insulin secretion (AIRg) and insulin sensitivity (S(I)) were derived from an iv @entity413 tolerance test. Postprandial @entity413 profile was recorded with a continuous @entity413 monitoring system. RESULTS: Area under the curve(0-120) of @entity5445 was larger after RYGBP compared with controls (P < 0.01) but was comparable among surgical groups (P =0.314). Time after surgery was not associated with changes in S(I) (P = 0.657), AIRg (P = 0.329), or the disposition index ( @entity6684 = AIRgS(I), P = 0.915). After surgery, the @entity5445 response and the @entity6684 were not significantly correlated (P = 0.304). @entity413 less than 50 mg/dl was found in operated subjects, but the proportion did not increase with time after surgery (P = 0.459). Neither the @entity5445 response (P = 0.620) nor the @entity6684 (P = 0.457) differed significantly between those with or without hypoglycemic episodes. CONCLUSIONS: Although the @entity5445 response to meal intake is steadily elevated after RYGBP, this does not result over time in the development of an inappropriate insulin secretion relative to the prevailing insulin sensitivity or the occurrence of hypoglycemic episodes.
