Abstract
BackgroundEnhanced secretion of glucagon-like peptide-1 (GLP-1) has been suggested as a possible mechanism underlying the improvement in type 2 diabetes mellitus (T2DM) after laparoscopic sleeve gastrectomy (LSG). However, the reason for enhanced GLP-1 secretion during glucose challenge after LSG remains unclear because LSG does not include intestinal bypass. In this study, we focused on the effects of LSG on GLP-1 secretion and intestinal motility during the oral glucose tolerance test (OGTT) using cine magnetic resonance imaging (MRI) before and 3 months after LSG.MethodsLSG was performed in 12 obese patients with a body mass index >35 kg/m2. Six patients had T2DM. OGTT was performed before and 3 months after the surgery. Body weight, hemoglobin A1c (HbA1c), and GLP-1 levels during OGTT were examined, and intestinal motility during OGTT was assessed using cine MRI.ResultsBody weight was significantly decreased after surgery in all the cases. HbA1c was markedly decreased in all the diabetic subjects. In all cases, GLP-1 secretion during OGTT was enhanced and cine MRI showed markedly increased intestinal motility at 15 and 30 min during OGTT after LSG.ConclusionsLSG leads to accelerated intestinal motility and reduced intestinal transit time, which may be involved in the mechanism underlying enhanced GLP-1 secretion during OGTT after LSG.
Highlights
Morbid obesity is currently a worldwide health problem because it promotes the development of various diseases, including cardiovascular disease and type 2 diabetes mellitus (T2DM), which considerably increase mortality
There was no significant difference in mean frequencies of contractions of the jejunum and ileum prior to glucose intake between before and after laparoscopic sleeve gastrectomy (LSG)
Previous studies have shown that LSG leads to improvement in glucose tolerance, which may be explained by the decrease in insulin resistance due to weight loss [17,18] and by the increase in insulin secretion due to enhanced glucagon-like peptide-1 (GLP-1) secretion [6,7,19,20]
Summary
Morbid obesity is currently a worldwide health problem because it promotes the development of various diseases, including cardiovascular disease and type 2 diabetes mellitus (T2DM), which considerably increase mortality. Current therapies, such as diet, exercise, lifestyle modification, and medication, seem to be insufficient for treating morbid obesity. Enhanced secretion of glucagon-like peptide-1 (GLP-1) has been suggested to be a mechanism underlying the improvement in T2DM after LSG [4,5,6,7]. Enhanced secretion of glucagon-like peptide-1 (GLP-1) has been suggested as a possible mechanism underlying the improvement in type 2 diabetes mellitus (T2DM) after laparoscopic sleeve gastrectomy (LSG). We focused on the effects of LSG on GLP-1 secretion and intestinal motility during the oral glucose tolerance test (OGTT) using cine magnetic resonance imaging (MRI) before and 3 months after LSG
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