Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery.
OBJECTIVE
To examine the impact of important weight loss on insulin inhibition of its own secretion during experimentally induced hyperinsulinemia under euglycemic conditions.


METHODS
Longitudinal, clinical intervention study--bariatric surgery (vertical banded gastroplasty--gastric bypass--Capella technique), re-evaluation after 4 and 14 months.


METHODS
Nine obese patients class III (BMI=54.6+/-2.6 kg/m2) and nine lean subjects (BMI=22.7+/-0.7 kg/m2).


METHODS
Euglycemic hyperinsulinemic clamp (insulin infusion: 40 mU/min m2), C-peptide plasma levels, electrical bioimpedance methodology, and oral glucose tolerance test (OGTT).


RESULTS
BMI was reduced in the follow-up: 44.5+/-2.2 and 33.9+/-1.5 kg/m2 at 4 and 14 months. Insulin-induced glucose uptake was markedly reduced in obese patients (19.5+/-1.9 micromol/min kg FFM) and improved with weight loss, but in the third study, it was still lower than that observed in controls (35.9+/-4.0 vs 52.9+/-2.2 micromol/min kg FFM). Insulin-induced inhibition of its own secretion was blunted in obese patients (19.9+/-5.7%, relative to fasting values), and completely reversed to values similar to that of lean ones in the second and third studies (-60.8+/-4.2 and -54.0+/-6.1%, respectively).


CONCLUSIONS
Weight loss in severe obesity improved insulin-induced glucose uptake, and completely normalized the insulin inhibition on its own secretion.
Pereira
J A
JA
Departmento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estudual de Campinas (UNICAMP), São Paulo, Brazil.
Claro
B M
BM
Pareja
J C
JC
Chaim
E A
EA
Astiarraga
B D
BD
Saad
M J A
MJ
Muscelli
E
E
D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D005215:Fasting / Q000097:blood; D005260:Female; D015391:Gastroplasty / Q000379:methods; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000378:metabolism*; D007328:Insulin / Q000378:metabolism / Q000502:physiology*; D000078790:Insulin Secretion; D008137:Longitudinal Studies; D008297:Male; D009767:Obesity, Morbid / Q000378:metabolism* / Q000601:surgery; D015431:Weight Loss
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin