期刊
DIABETES
卷 63, 期 2, 页码 483-493出版社
AMER DIABETES ASSOC
DOI: 10.2337/db13-0954
关键词
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资金
- Mayo Clinic General Clinical Research Center [NIH DK TR000135]
- NIH [R01 DK-78646, R01 DK-82396]
The contribution of elevated glucagon-like peptide 1 (GLP-1) to postprandial glucose metabolism after Roux-en-Y gastric bypass (RYGB) has been the subject of uncertainty. We used exendin-9,39, a competitive antagonist of GLP-1, to examine glucose metabolism, islet hormone secretion, and gastrointestinal transit in subjects after RYGB and in matched control subjects. Subjects were studied in the presence or absence of exendin-9,39 infused at 300 pmol/kg/min. Exendin-9,39 resulted in an increase in integrated postprandial glucose concentrations post-RYGB (3.6 +/- 0.5 vs. 2.0 +/- 0.4 mol/6 h, P = 0.001). Exendin-9,39 decreased insulin concentrations (12.3 +/- 2.2 vs. 18.1 +/- 3.1 nmol/6 h, P = 0.002) and the -cell response to glucose (phi(Total), 13 +/- 1 vs. 11 +/- 1 x 10(-9) min(,)(-1)P = 0.01) but did not alter the disposition index (DI). In control subjects, exendin-9,39 also increased glucose (2.2 +/- 0.4 vs. 1.7 +/- 0.3 mol/6 h, P = 0.03) without accompanying changes in insulin concentrations, resulting in an impaired DI. Post-RYGB, acceleration of stomach emptying during the first 30 min by exendin-9,39 did not alter meal appearance, and similarly, suppression of glucose production and stimulation of glucose disappearance were unaltered in RYGB subjects. These data indicate that endogenous GLP-1 has effects on glucose metabolism and on gastrointestinal motility years after RYGB. However, it remains uncertain whether this explains all of the changes after RYGB.
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