Changes of blood glucose and gastrointestinal hormones 4months after Roux-en-Y gastric bypass surgery in Chinese obese type2 diabetes patients with lower body mass index.

Abstract

The goal of this study was to evaluate the effect of Roux-en-Y gastric bypass (RYGB) on hyperglycemia and gastrointestinal hormones in Chinese obese type 2 diabetic patients with body mass index (BMI) between 28 and 35kg/m(2). A total of eight obese type 2 diabetes patients with BMI 28-35kg/m(2) who underwent RYGB and 10 obese normal glucose tolerance (NGT) patients with no surgery were identified. BMI and blood glucose on baseline, and 2-4months postoperative, changes of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), peptide YY (PYY), and oxyntomodulin (OXM) were recorded. Efficacy of RYGB was defined by the percentage of excess weight loss (%EWL) and amelioration of type 2 diabetes. The %EWL was 53.00±26.25% in 2month and 63.65±33.71% in 4month. Glycated hemoglobin changed from 7.2±1.0% preoperative to 6.2±0.9% in 2month and 6.3±1.2% in 4month postoperative. The improvement rate of type 2 diabetes 4 months after RYGB was 83.3%. After surgery, area under the curve (AUC) GLP-1 120 increased with no significance. AUC PYY 120 changed from 10.37±5.45pmol/L/min preoperative to 22.19±10.61pmol/L/min in 2month and 22.04±7.73pmol/L/min in 4month postoperative. Postoperative AUC OXM 120 was also higher than that of the preoperative level. AUC GIP 120 decreased from 13.06±8.45pg/mL/min preoperative to 8.71±3.28pg/ml/min in 2month and 6.88±2.33pg/mL/min in 4month postoperative. Roux-en-Y gastric bypass has a beneficial effect on weight loss and glucose metabolism in obese type 2 diabetes patients with lower BMI. Postoperative concentrations of GLP-1, PYY and OXM increased, whereas GIP decreased.