Short-term overfeeding induces insulin resistance in weight-stable patients after bariatric surgery.
BACKGROUND
Short time overfeeding of rats rapidly leads to insulin resistance (IR). A study with healthy human volunteers, which we suggest are less susceptible for developing IR after short time overfeeding, did not show these effects on IR. Therefore a study population of weight-stable, former morbidly obese subjects (BMI 31.3 kg/m2), which were treated with bariatric surgery approximately 3 years ago was selected.


METHODS
Eleven subjects were submitted to a 7-day overfeeding study, resulting in a 53% increase in caloric intake (1,227 +/- 394.4 to 1,879.2 +/- 298.4 kcal/day). During normal diet and after overfeeding, insulin sensitivity was measured using steady state plasma glucose (SSPG) levels. At these time points, BMI and waist/hip ratio together with plasma levels of inflammatory markers (CRP, AGP, LBP, and TNF-alpha receptors) and plasma leptin values were also measured.


RESULTS
SSPG levels after overfeeding increased from 8.2 +/- 3.2 to 10.6 +/- 2.6 mmol/l (P < 0.05), indicating decreased insulin sensitivity after overfeeding. Fasting plasma insulin, glucose, circulating levels of inflammatory markers, BMI, and waist/hip ratio remained unchanged.


CONCLUSIONS
This study shows that overfeeding in a group of weight-stable, former morbidly obese subjects 3 years after bariatric surgery results in decreased insulin sensitivity. The mechanisms behind decreased insulin sensitivity induced by overfeeding are poorly understood, but the present results reveal that a unique human model is available to study these mechanisms, leading to a better understanding of the pathophysiology of IR.
Nijhuis
Jeroen
J
Nutrition and Toxicology Research Institute Maastricht, Department of General Surgery, Maastricht University/University Hospital Maastricht, PO Box 616, 6200 MD, Maastricht, The Netherlands.
van Dielen
Francois M H
FM
Schaper
Nicolaas C
NC
Wiebolt
Janneke
J
Koks
Afra
A
Prakken
Fred J
FJ
Rensen
Sander S M
SS
Buurman
Wim A
WA
Greve
Jan Willem M
JW
D000328:Adult; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D004435:Eating; D002149:Energy Intake; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery
D001786:Blood Glucose; D018836:Inflammation Mediators; D020738:Leptin; D002097:C-Reactive Protein