Race affects insulin and GLP-1 secretion and response to a long-acting somatostatin analogue in obese adults.
OBJECTIVE
This study investigated (1) the effect of octreotide-LAR (Sandostatin-LAR Depot; Novartis) on the enteroinsular axis in a biracial cohort of severely obese adults, (2) whether octreotide suppression of insulin secretion occurs by both a direct beta-cell effect and through mediating a glucagon-like peptide 1 (GLP-1) response, and (3) whether differences in GLP-1 concentrations could explain racial differences in insulin concentrations.


METHODS
Prospective, open-label trial using a pre-post test design.


METHODS
Single university, clinical research center.


METHODS
In all, 42 healthy, severely obese Caucasian and African-American (AA) adults (93% female, 64% Caucasian, age=37.8+/-1.2 y, weight=123+/-4.2 kg, BMI=44.5+/-1 kg/m(2)), recruited through physician referral and newspaper ads, participated in the study.


METHODS
Indices of beta-cell activity, insulin and GLP-1 response before and during a 75-gm oral glucose tolerance test were determined before and after 24 weeks of octreotide-LAR.


RESULTS
AA exhibited higher beta-cell activity, and insulin and GLP-1 concentrations than Caucasians. Octreotide-LAR suppressed the insulin and GLP-1 levels in both groups.
Velasquez-Mieyer
P A
PA
Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA. pvelasquez@utmem.edu
Umpierrez
G E
GE
Lustig
R H
RH
Cashion
A K
AK
Cowan
P A
PA
Christensen
M
M
Spencer
K A
KA
Burghen
G A
GA
D000328:Adult; D001741:Black or African American; D000886:Anthropometry; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005934:Glucagon / Q000378:metabolism*; D052216:Glucagon-Like Peptide 1; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008297:Male; D009765:Obesity / Q000188:drug therapy / Q000208:ethnology* / Q000378:metabolism; D015282:Octreotide / Q000627:therapeutic use*; D010446:Peptide Fragments / Q000378:metabolism*; D011446:Prospective Studies; D011498:Protein Precursors / Q000378:metabolism*; D044465:White People
D005765:Gastrointestinal Agents; D007328:Insulin; D010446:Peptide Fragments; D011498:Protein Precursors; D052216:Glucagon-Like Peptide 1; D005934:Glucagon; D015282:Octreotide