Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes

Blandine Laferrère, Nicholas Swerdlow, Baani Bawa, Sara Arias, Mousumi Bose, Blanca Oliván, Julio Teixeira, James McGinty, Kristina I. Rother

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Abstract

Context: The mechanisms by which Roux-en-Y gastric bypass surgery (GBP) results in sustained weight loss and remission of type 2 diabetes are not fully understood. Objective: We hypothesized that the anorexic hormone oxyntomodulin (OXM) might contribute to the marked weight reduction and the rapid improvement in glucose metabolism observed in morbidly obese diabetic patients after GBP. Methods: Twenty obese women with type 2 diabetes were studied before and 1 month after GBP (n = 10) or after a diet-induced equivalent weight loss (n = 10). Patients from both groups were matched for age, body weight, body mass index, and diabetes duration and control. OXM concentrations were measured during a 50-g oral glucose challenge before and after weight loss. Results: At baseline, OXM levels (fasting and stimulated values) were indistinguishable between the GBP and the diet group. However, OXM levels rose remarkably in response to an oral glucose load more than 2-fold (peak, 5.25 ± 1.31 to13.8 ± 16.2 pmol/liter; P=0.025) after GBP but not after diet. The peak of OXM after glucose was significantly correlated with glucagon-like peptide-1 and peptide YY3-36. Conclusions: Our data suggest that the observed changes in OXM primarily occur in response to GBP and not as a consequence of weight loss. These changes were observed early after surgery and occurred in parallel with previously reported increases in incretins and peptide YY. We speculate that the combination of gut hormone changes is essential for the improved glucose homeostasis and may partially explain the success of this surgery on diabetes resolution and weight loss.

Original languageEnglish
Pages (from-to)4072-4076
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number8
DOIs
StatePublished - 1 Jan 2010

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Oxyntomodulin
Gastric Bypass
Medical problems
Surgery
Type 2 Diabetes Mellitus
Glucose
Weight Loss
Nutrition
Diet
Hormones
Peptide YY
Incretins
Glucagon-Like Peptide 1
Metabolism
Fasting
Body Mass Index
Homeostasis
Research Design
Body Weight

Cite this

Laferrère, Blandine ; Swerdlow, Nicholas ; Bawa, Baani ; Arias, Sara ; Bose, Mousumi ; Oliván, Blanca ; Teixeira, Julio ; McGinty, James ; Rother, Kristina I. / Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes. In: Journal of Clinical Endocrinology and Metabolism. 2010 ; Vol. 95, No. 8. pp. 4072-4076.
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abstract = "Context: The mechanisms by which Roux-en-Y gastric bypass surgery (GBP) results in sustained weight loss and remission of type 2 diabetes are not fully understood. Objective: We hypothesized that the anorexic hormone oxyntomodulin (OXM) might contribute to the marked weight reduction and the rapid improvement in glucose metabolism observed in morbidly obese diabetic patients after GBP. Methods: Twenty obese women with type 2 diabetes were studied before and 1 month after GBP (n = 10) or after a diet-induced equivalent weight loss (n = 10). Patients from both groups were matched for age, body weight, body mass index, and diabetes duration and control. OXM concentrations were measured during a 50-g oral glucose challenge before and after weight loss. Results: At baseline, OXM levels (fasting and stimulated values) were indistinguishable between the GBP and the diet group. However, OXM levels rose remarkably in response to an oral glucose load more than 2-fold (peak, 5.25 ± 1.31 to13.8 ± 16.2 pmol/liter; P=0.025) after GBP but not after diet. The peak of OXM after glucose was significantly correlated with glucagon-like peptide-1 and peptide YY3-36. Conclusions: Our data suggest that the observed changes in OXM primarily occur in response to GBP and not as a consequence of weight loss. These changes were observed early after surgery and occurred in parallel with previously reported increases in incretins and peptide YY. We speculate that the combination of gut hormone changes is essential for the improved glucose homeostasis and may partially explain the success of this surgery on diabetes resolution and weight loss.",
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Laferrère, B, Swerdlow, N, Bawa, B, Arias, S, Bose, M, Oliván, B, Teixeira, J, McGinty, J & Rother, KI 2010, 'Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes', Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 8, pp. 4072-4076. https://doi.org/10.1210/jc.2009-2767

Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes. / Laferrère, Blandine; Swerdlow, Nicholas; Bawa, Baani; Arias, Sara; Bose, Mousumi; Oliván, Blanca; Teixeira, Julio; McGinty, James; Rother, Kristina I.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 8, 01.01.2010, p. 4072-4076.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes

AU - Laferrère, Blandine

AU - Swerdlow, Nicholas

AU - Bawa, Baani

AU - Arias, Sara

AU - Bose, Mousumi

AU - Oliván, Blanca

AU - Teixeira, Julio

AU - McGinty, James

AU - Rother, Kristina I.

PY - 2010/1/1

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N2 - Context: The mechanisms by which Roux-en-Y gastric bypass surgery (GBP) results in sustained weight loss and remission of type 2 diabetes are not fully understood. Objective: We hypothesized that the anorexic hormone oxyntomodulin (OXM) might contribute to the marked weight reduction and the rapid improvement in glucose metabolism observed in morbidly obese diabetic patients after GBP. Methods: Twenty obese women with type 2 diabetes were studied before and 1 month after GBP (n = 10) or after a diet-induced equivalent weight loss (n = 10). Patients from both groups were matched for age, body weight, body mass index, and diabetes duration and control. OXM concentrations were measured during a 50-g oral glucose challenge before and after weight loss. Results: At baseline, OXM levels (fasting and stimulated values) were indistinguishable between the GBP and the diet group. However, OXM levels rose remarkably in response to an oral glucose load more than 2-fold (peak, 5.25 ± 1.31 to13.8 ± 16.2 pmol/liter; P=0.025) after GBP but not after diet. The peak of OXM after glucose was significantly correlated with glucagon-like peptide-1 and peptide YY3-36. Conclusions: Our data suggest that the observed changes in OXM primarily occur in response to GBP and not as a consequence of weight loss. These changes were observed early after surgery and occurred in parallel with previously reported increases in incretins and peptide YY. We speculate that the combination of gut hormone changes is essential for the improved glucose homeostasis and may partially explain the success of this surgery on diabetes resolution and weight loss.

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