Українська English

ISSN 2522-9028 (Print)
ISSN 2522-9036 (Online)
DOI: https://doi.org/10.15407/fz

Fiziologichnyi Zhurnal

is a scientific journal issued by the

Bogomoletz Institute of Physiology
National Academy of Sciences of Ukraine

Editor-in-chief: V.F. Sagach

The journal was founded in 1955 as
1955 – 1977 "Fiziolohichnyi zhurnal" (ISSN 0015 – 3311)
1978 – 1993 "Fiziologicheskii zhurnal" (ISSN 0201 – 8489)
1994 – 2016 "Fiziolohichnyi zhurnal" (ISSN 0201 – 8489)
2017 – "Fiziolohichnyi zhurnal" (ISSN 2522-9028)

Fiziol. Zh. 2021; 67(4): 44-51

DYNAMICS OF GLUCAGON-LIKE PEPTIDE-1 AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS ASSOCIATIONS WITH OBESITY

I.M. Todurov, S.V. Kosiukhno, O.V. Perekhrestenko, O.O. Kalashnikov, O.А. Potapov, О.І. Plehutsa

    State Scientific Institution “Center for Innovative Medical Technologies of the National Academy of Sciences of Ukraine”, Kiev, Ukraine
DOI: https://doi.org/10.15407/fz67.04.044


Abstract

Laparoscopic sleeve gastrectomy (LSG) proved to be a valuable procedure for treating obesity complicated by type 2 diabetes mellitus (T2DM). The mechanism of T2DM resolution after LSG is not yet clearly defined. The objective of the study was to investigate the effect of LSG on the secretion of GLP-1 in patients with T2DM associated with obesity. Plasma GLP-1 levels were evaluated by starvation and 15, 30, 60 and 90 min after the standard carbohydrate preload for breakfast, which included 125 ml of balanced high energy Nutricia Nutridrink Protein. Evaluations were made on the eve of the procedure, for 4 days and 3 months after the operation. In 7 patients with T2DM were diagnosed for the first time, in 3 patients with diabetic history 2 years, in 1 patient – 3.5 years and in 1 patient – 10 years. Mean glycated hemoglobin before surgery was 7.7 ± 1.6%, 3 months after LSG – 5.9 ± 0.4%. The concentration of GLP-1 in 30 minutes before surgery was 6.7 ± 0.9 ng/ml. On the 4th day after LSG, the mean level of GLP-1 was 9.6 ± 0.2 ng/ml, which statistically differed from its level in the pre-operative period, and after 3 months the mean level of GLP-1 statistically increased to 13.7 ± 0.3 ng/ml. Thus LSG leads to an early and significant increase in post-prandial secretion GLP-1 in T2DM patients associated with obesity. The rapid postoperative improvement in signs of carbohydrate metabolism indicates the importance of the incretin effect LSG in the implementation of early compensation mechanisms for T2DM and explains the metabolic activity of this operation.

Keywords: type 2 diabetes mellitus associated with obesity; bariatric surgery; laparoscopic sleeve gastrectomy: glucagonlike peptide 1

Full text: (PDF, in Ukrainian)

References

  1. Holst JJ. Glucagonlike peptide 1: a newly discovered gastrointestinal hormone. Gastroenterology. 1994 Dec;107(6):1848-55. PMID: 7958701. CrossRef
  2. Park JH, Stoffers DA, Nicholls RD, Simmons RA. Development of type 2 diabetes following intrauterine growth retardation in rats is associated with progressive epigenetic silencing of Pdx1. J Clin Invest. 2008 Jun;118(6):2316-24. CrossRef PubMed PubMedCentral
  3. Xu G, Stoffers DA, Habener JF, Bonner-Weir S. Exendin-4 stimulates both beta-cell replication and neogenesis, resulting in increased beta-cell mass and improved glucose tolerance in diabetic rats. Diabetes. 1999 Dec;48(12):2270-6. CrossRef PubMed
  4. Stoffers DA, Kieffer TJ, Hussain MA, Drucker DJ, Bonner-Weir S, Habener JF, Egan JM. Insulinotropic glucagon-like peptide 1 agonists stimulate expression of homeodomain protein IDX-1 and increase islet size in mouse pancreas. Diabetes. 2000 May;49(5):741-8. CrossRef PubMed
  5. Li F, Peng Y, Zhang M, Yang P, Qu S. Sleeve gastrectomy activates the GLP-1 pathway in pancreatic β cells and promotes GLP-1-expressing cells differentiation in the intestinal tract. Mol Cell Endocrinol. 2016 Nov 15;436:33-40. CrossRef PubMed
  6. Seyfried F, Miras AD, Rotzinger L, Nordbeck A, Corteville C, Li JV, Schlegel N, Hankir M, Fenske W, Otto C, Jurowich C. Gastric bypass-related effects on glucose control, β cell function and morphology in the obese zucker rat. Obes Surg. 2016 Jun;26(6):1228-36. CrossRef PubMed
  7. Dimitriadis GK, Randeva MS, Miras AD. Potential hormone mechanisms of bariatric surgery. Current Obes Rep. 2017 Sep;6(3):253-65. CrossRef PubMed PubMedCentral
  8. Jiménez A, Mari A, Casamitjana R, Lacy A, Ferrannini E, Vidal J. GLP-1 and glucose tolerance after sleeve gastrectomy in morbidly obese subjects with type 2 diabetes. Diabetes. 2014 Oct;63(10):3372-7. CrossRef PubMed
  9. Hutch CR, Sandoval D. The role of GLP-1 in the metabolic success of bariatric surgery. Endocrinology. 2017 Dec 1;158(12):4139-51. CrossRef PubMed PubMedCentral
  10. Madsbad S, Holst JJ. GLP-1 as a mediator in the remission of type 2 diabetes after gastric bypass and sleeve gastrectomy surgery. Diabetes. 2014 Oct;63(10):3172-4. CrossRef PubMed
  11. Affinati AH, Esfandiari NH, Oral EA, Kraftson AT. Bariatric surgery in the treatment of type 2 diabetes. Current Diab Rep. 2019 Dec 4;19(12):156. CrossRef PubMed PubMedCentral
  12. Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, Buchwald H, Scopinaro N. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg. 2018 Dec;28(12):3783-94. CrossRef PubMed
  13. Gumbs A, Gagner M, Dakin G, Pomp A. sleeve gastrectomy for morbid obesity. Obes Surg. 2007 Jul;17:962-9. CrossRef PubMed
  14. Todurov IM, Belyansky LS, Perekhrestenko AV, Razdobudko UM, Kalashnikov AA, Kosyukhno SV. Mechanisms of sleeve-gastrectomy effectiveness: only gastrorestriction? Diabetes Obes Metabolic Syndr. 2015; 1 (IV): 28-33. [Russian].
  15. Drucker DJ. The biology of incretin hormones. Cell Metab. 2006 Mar;3(3):153-65. CrossRef PubMed
  16. Wøjdemann M, Wettergren A, Hartmann B, Hilsted L, and Holst JJ. Inhibition of sham feeding-stimulated human gastric acid secretion by glucagon-like peptide-2. J. Clin. Endocrinol. Metab. 1999;84, 2513-7. CrossRef PubMed
  17. O'Brien R, Johnson E, Haneuse S, et al. Microvascular outcomes in patients with diabetes after bariatric surgery versus usual care: a matched cohort study. Ann Int Med. 2018;169(5):300-10. CrossRef PubMed PubMedCentral
  18. van Dijk G, Thiele TE. Glucagon-like peptide-1 (7-36) amide: a central regulator of satiety and interoceptive stress. Neuropeptides. 1999 Oct;33(5):406-14. CrossRef PubMed
  19. Meeran K, O'Shea D, Edwards CM, Turton MD, Heath MM, Gunn I, Abusnana S, Rossi M, Small CJ, Goldstone AP, Taylor GM, Sunter D, Steere J, Choi SJ, Ghatei MA, Bloom SR. Repeated intracerebroventricular administration of glucagon-like peptide-1-(7-36) amide or exendin-(9-39) alters body weight in the rat. Endocrinology. 1999 Jan;140(1):244-50. CrossRef PubMed
  20. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859-63. CrossRef PubMed
  21. Parpex G, Demouron M, Arapis K,Chosidow D, Rebibo L, Msika S. The Distance between the pylorus and left vagus nerve during sleeve gastrectomy. Clin Anat. 2020;33(4):562-66. CrossRef PubMed
  22. Bartosiak K, Różańska-Walędziak A, Walędziak M, Kowalewski P, Paśnik K, Janik MR. The safety and benefits of laparoscopic sleeve gastrectomy in elderly patients: a case-control study. Obes Surg. 2019 Jul;29(7):2233-7. CrossRef PubMed
  23. Benaiges D, Más-Lorenzo A, Goday A, Ramon JM, Chillarón JJ, Pedro-Botet J, Flores-Le Roux JA. Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure? World J Gastroenterol. 2015 Nov 7;21(41):11804-14. CrossRef PubMed PubMedCentral
  24. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009 JulAug;5(4):469-75. CrossRef PubMed
  25. Gill RS, Sharma AM, Al-Adra DP, Birch DW, Karmali S. The impact of bariatric surgery in patients with type-2 diabetes mellitus. Current Diabetes Rev. 2011 May;7(3):185-9. CrossRef PubMed
  26. Saltiel AR, Kahn CR. Insulin signalling and the regulation of glucose and lipid metabolism. Nature. 2001Dec 13;414(6865):799-806. CrossRef PubMed
  27. Meier JJ, Gallwitz B, Salmen S, Goetze O, Holst JJ, Schmidt WE, Nauck MA. Normalization of glucose concentrations and deceleration of gastric emptying after solid meals during intravenous glucagon-like peptide 1 in patients with type 2 diabetes. J Clin Endocrinol Metab. 2003 Jun;88(6):2719-25. CrossRef PubMed
  28. Peterli R, Wölnerhanssen B, Peters T, Devaux N, Kern B, Christoffel-Courtin C, Drewe J, von Flüe M, Beglinger C. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009 Aug;250(2):234-41. CrossRef PubMed
  29. Basso N, Capoccia D, Rizzello M, Abbatini F, Mariani P, Maglio C, Coccia F, Borgonuovo G, De Luca ML, Asprino R, Alessandri G, Casella G, Leonetti F. Firstphase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients: the gastric hypothesis. Surg Endosc. 2011 Nov;25(11):3540-50. CrossRef PubMed
  30. Casella G, Abbatini F, Calì B, Capoccia D, Leonetti F, Basso N. Ten-year duration of type 2 diabetes as prognostic factor for remission after sleeve gastrectomy. Surg Obes Relat Dis. 2011 Nov-Dec;7(6):697-702. CrossRef PubMed
© National Academy of Sciences of Ukraine, Bogomoletz Institute of Physiology, 2014-2024.