Laparoscopic greater curvature plication in morbidly obese women with type 2 diabetes: effects on glucose homeostasis, postprandial triglyceridemia and selected gut hormones
Jazyk angličtina Země Spojené státy americké Médium print
Typ dokumentu hodnotící studie, časopisecké články, práce podpořená grantem
- MeSH
- časové faktory MeSH
- diabetes mellitus 2. typu komplikace metabolismus MeSH
- gastrointestinální hormony metabolismus MeSH
- gastroplastika metody MeSH
- ghrelin metabolismus MeSH
- glukagonu podobný peptid 1 metabolismus MeSH
- hmotnostní úbytek * MeSH
- homeostáza MeSH
- index tělesné hmotnosti MeSH
- krevní glukóza metabolismus MeSH
- laparoskopie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- morbidní obezita metabolismus chirurgie MeSH
- následné studie MeSH
- postprandiální období MeSH
- triglyceridy metabolismus MeSH
- výsledek terapie MeSH
- žaludeční inhibiční polypeptid metabolismus MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
- Názvy látek
- gastrointestinální hormony MeSH
- ghrelin MeSH
- glukagonu podobný peptid 1 MeSH
- krevní glukóza MeSH
- triglyceridy MeSH
- žaludeční inhibiční polypeptid MeSH
BACKGROUND: Laparoscopic greater curvature plication (LGCP) is an emerging bariatric procedure that reduces the gastric volume without implantable devices or gastrectomy. The aim of this study was to explore changes in glucose homeostasis, postprandial triglyceridemia, and meal-stimulated secretion of selected gut hormones [glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1), ghrelin, and obestatin] in patients with type 2 diabetes mellitus (T2DM) at 1 and 6 months after the procedure. METHODS: Thirteen morbidly obese T2DM women (mean age, 53.2 ± 8.76 years; body mass index, 40.1 ± 4.59 kg/m2) were prospectively investigated before the LGCP and at 1- and 6-month follow-up. At these time points, all study patients underwent a standardized liquid mixed-meal test, and blood was sampled for assessment of plasma levels of glucose, insulin, C-peptide, triglycerides, GIP, GLP-1, ghrelin, and obestatin. RESULTS: All patients had significant weight loss both at 1 and 6 months after the LGCP (p ≤ 0.002), with mean percent excess weight loss (%EWL) reaching 29.7 ± 2.9% at the 6-month follow-up. Fasting hyperglycemia and hyperinsulinemia improved significantly at 6 months after the LGCP (p < 0.05), with parallel improvement in insulin sensitivity and HbA1c levels (p < 0.0001). Meal-induced glucose plasma levels were significantly lower at 6 months after the LGCP (p < 0.0001), and postprandial triglyceridemia was also ameliorated at the 6-month follow-up (p < 0.001). Postprandial GIP plasma levels were significantly increased both at 1 and 6 months after the LGCP (p < 0.0001), whereas the overall meal-induced GLP-1 response was not significantly changed after the procedure (p > 0.05). Postprandial ghrelin plasma levels decreased at 1 and 6 months after the LGCP (p < 0.0001) with no significant changes in circulating obestatin levels. CONCLUSION: During the initial 6-month postoperative period, LGCP induces significant weight loss and improves the metabolic profile of morbidly obese T2DM patients, while it also decreases circulating postprandial ghrelin levels and increases the meal-induced GIP response.
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