Improved acylated ghrelin suppression at 2 years in obese patients with type 2 diabetes: effects of bariatric surgery vs standard medical therapy

Roux-en-Y gastric bypass (RYGB) produces more durable glycemic control than sleeve gastrectomy (SG) or intensive medical therapy (IMT). However, the contribution of acylated ghrelin (AG), a gluco-regulatory/appetite hormone, to improve glucose metabolism and body composition in patients with type 2...

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Bibliographic Details
Published in:International Journal of Obesity 2014-03, Vol.38 (3), p.364-370
Main Authors: MALIN, S. K, SAMAT, A, KASHYAP, S. R, WOLSKI, K, ABOOD, B, POTHIER, C. E, BHATT, D. L, NISSEN, S, BRETHAUER, S. A, SCHAUER, P. R, KIRWAN, J. P
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
Acylation
Anti-Obesity Agents
Appetite
Beta cells
Biological and medical sciences
Blood Glucose - metabolism
Body composition
Body fat
Body mass
Body Mass Index
Body size
Care and treatment
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - metabolism
Diabetes Mellitus, Type 2 - surgery
Diabetes. Impaired glucose tolerance
Dual energy X-ray absorptiometry
Endocrine pancreas. Apud cells (diseases)
Endocrinology
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Fasting
Feeding Behavior
Female
Gastrectomy
Gastric Bypass
Gastrointestinal surgery
Ghrelin
Ghrelin - metabolism
Glucagon
Glucagon-like peptide 1
Glucose
Glucose metabolism
Glycated Hemoglobin A - metabolism
Hemoglobin
Humans
Indexing
Insulin
Insulin - metabolism
Insulin resistance
Insulin Secretion
Laboratory testing
Male
Measurement
Medical sciences
Metabolic diseases
Metabolism
Methyltestosterone
Middle Aged
Nutrition therapy
Obesity
Obesity, Morbid - complications
Obesity, Morbid - metabolism
Obesity, Morbid - surgery
Patient outcomes
Patients
Peptides
Physiological aspects
Postprandial Period
Prospective Studies
Secretion
Stomach, duodenum, intestine, rectum, anus
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Treatment Outcome
Type 2 diabetes
Weight control
Weight Loss
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Summary:Roux-en-Y gastric bypass (RYGB) produces more durable glycemic control than sleeve gastrectomy (SG) or intensive medical therapy (IMT). However, the contribution of acylated ghrelin (AG), a gluco-regulatory/appetite hormone, to improve glucose metabolism and body composition in patients with type 2 diabetes (T2D) following RYGB is unknown. STAMPEDE (Surgical Treatment and Medication Potentially Eradicate Diabetes Efficiently) was a prospective, randomized controlled trial. Fifty-three (body mass index: 36±3 kg m(-2), age: 49±9 years) poorly controlled patients with T2D (HbA1c (glycated hemoglobin): 9.7±2%) were randomized to IMT, IMT+RYGB or IMT+SG and underwent a mixed-meal tolerance test at baseline, 12, and 24 months for evaluation of AG suppression (postprandial minus fasting) and beta-cell function (oral disposition index; glucose-stimulated insulin secretion × Matsuda index). Total/android body fat (dual-energy X-ray absorptiometry) was also assessed. RYGB and SG reduced body fat comparably (15-23 kg) at 12 and 24 months, whereas IMT had no effect. Beta-cell function increased 5.8-fold in RYGB and was greater than IMT at 24 months (P
ISSN:0307-0565
1476-5497
DOI:10.1038/ijo.2013.196