Accelerated Gastric Emptying but No Carbohydrate Malabsorption 1 Year After Gastric Bypass Surgery (GBP)

Background Following gastric bypass surgery (GBP), there is a post-prandial rise of incretin and satiety gut peptides. The mechanisms of enhanced incretin release in response to nutrients after GBP is not elucidated and may be in relation to altered nutrient transit time and/or malabsorption. Method...

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Bibliographic Details
Published in:Obesity surgery 2012-08, Vol.22 (8), p.1263-1267
Main Authors: Wang, Gary, Agenor, Keesandra, Pizot, Justine, Kotler, Donald P., Harel, Yaniv, Van Der Schueren, Bart J., Quercia, Iliana, McGinty, James, Laferrère, Blandine
Format: Article
Language:English
Subjects:
Adult
Clinical Research
Dietary Carbohydrates - metabolism
Female
Gastric Bypass
Gastric Emptying
Gastrointestinal surgery
Glycated Hemoglobin A - metabolism
Humans
Incretins - metabolism
Intestinal Absorption
Intestine, Small - metabolism
Intestine, Small - physiopathology
Intestine, Small - surgery
Malabsorption Syndromes - metabolism
Male
Medicine
Medicine & Public Health
Middle Aged
Nutrition
Obesity
Obesity, Morbid - metabolism
Obesity, Morbid - physiopathology
Obesity, Morbid - surgery
Postprandial Period
Surgery
Weight Loss
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Summary:Background Following gastric bypass surgery (GBP), there is a post-prandial rise of incretin and satiety gut peptides. The mechanisms of enhanced incretin release in response to nutrients after GBP is not elucidated and may be in relation to altered nutrient transit time and/or malabsorption. Methods Seven morbidly obese subjects (BMI = 44.5 ± 2.8 kg/m 2 ) were studied before and 1 year after GBP with a d -xylose test. After ingestion of 25 g of d -xylose in 200 mL of non-carbonated water, blood samples were collected at frequent time intervals to determine gastric emptying (time to appearance of d -xylose) and carbohydrate absorption using standard criteria. Results One year after GBP, subjects lost 45.0 ± 9.7 kg and had a BMI of 27.1 ± 4.7 kg/m 2 . Gastric emptying was more rapid after GBP. The mean time to appearance of d -xylose in serum decreased from 18.6 ± 6.9 min prior to GBP to 7.9 ± 2.7 min after GBP ( p  = 0.006). There was no significant difference in absorption before (serum d -xylose concentrations = 35.6 ± 12.6 mg/dL at 60 min and 33.9 ± 9.1 mg/dL at 180 min) or 1 year after GBP (serum d -xylose = 31.5 ± 18.1 mg/dL at 60 min and 27.2 ± 11.9 mg/dL at 180 min). Conclusions These data confirm the acceleration of gastric emptying for liquid and the absence of carbohydrate malabsorption 1 year after GBP. Rapid gastric emptying may play a role in incretin response after GBP and the resulting improved glucose homeostasis.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-012-0656-6