Endocrine effects of duodenal-jejunal exclusion in obese patients with type 2 diabetes mellitus
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu hodnotící studie, časopisecké články
PubMed
27474690
DOI
10.1530/joe-16-0206
PII: JOE-16-0206
Knihovny.cz E-zdroje
- Klíčová slova
- bile acids, duodenal–jejunal bypass liner, fibroblast growth factor 19, obesity, type 2 diabetes mellitus,
- MeSH
- bariatrická chirurgie metody MeSH
- časové faktory MeSH
- diabetes mellitus 2. typu etiologie metabolismus chirurgie MeSH
- dospělí MeSH
- duodenum chirurgie MeSH
- fibroblastové růstové faktory krev MeSH
- glukagonu podobný peptid 1 krev MeSH
- hmotnostní úbytek MeSH
- jejunum chirurgie MeSH
- krevní glukóza metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipidy krev MeSH
- obezita komplikace metabolismus chirurgie MeSH
- pooperační období MeSH
- postprandiální období MeSH
- senioři MeSH
- výsledek terapie MeSH
- žlučové kyseliny a soli krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- Názvy látek
- FGF19 protein, human MeSH Prohlížeč
- fibroblastové růstové faktory MeSH
- glukagonu podobný peptid 1 MeSH
- krevní glukóza MeSH
- lipidy MeSH
- žlučové kyseliny a soli MeSH
Duodenal-jejunal bypass liner (DJBL) is an endoscopically implantable device designed to noninvasively mimic the effects of gastrointestinal bypass operations by excluding the duodenum and proximal jejunum from the contact with ingested food. The aim of our study was to assess the influence of DJBL on anthropometric parameters, glucose regulation, metabolic and hormonal profile in obese patients with type 2 diabetes mellitus (T2DM) and to characterize both the magnitude and the possible mechanisms of its effect. Thirty obese patients with poorly controlled T2DM underwent the implantation of DJBL and were assessed before and 1, 6 and 10months after the implantation, and 3months after the removal of DJBL. The implantation decreased body weight, and improved lipid levels and glucose regulation along with reduced glycemic variability. Serum concentrations of fibroblast growth factor 19 (FGF19) and bile acids markedly increased together with a tendency to restoration of postprandial peak of GLP1. White blood cell count slightly increased and red blood cell count decreased throughout the DJBL implantation period along with decreased ferritin, iron and vitamin B12 concentrations. Blood count returned to baseline values 3months after DJBL removal. Decreased body weight and improved glucose control persisted with only slight deterioration 3months after DJBL removal while the effect on lipids was lost. We conclude that the implantation of DJBL induced a sustained reduction in body weight and improvement in regulation of lipid and glucose. The increase in FGF19 and bile acids levels could be at least partially responsible for these effects.
Citace poskytuje Crossref.org
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