title: Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery.
abstract: 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.
authors.affiliation: Departmento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estudual de Campinas (UNICAMP), São Paulo, Brazil.
authors.forename: J A
authors.initials: JA
authors.lastname: Pereira
authors.forename: B M
authors.initials: BM
authors.lastname: Claro
authors.forename: J C
authors.initials: JC
authors.lastname: Pareja
authors.forename: E A
authors.initials: EA
authors.lastname: Chaim
authors.forename: B D
authors.initials: BD
authors.lastname: Astiarraga
authors.forename: M J A
authors.initials: MJ
authors.lastname: Saad
authors.forename: E
authors.initials: E
authors.lastname: Muscelli
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin