title: Dissociated incretin response to oral glucose at 1 year after restrictive vs. malabsorptive bariatric surgery.
abstract: OBJECTIVE
  Compare the response to oral glucose of the two incretin hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) at 1 year after restrictive vs. malabsorptive bariatric surgery.
  
  
  METHODS
  Vertical banded gastroplasty (VBG, n = 7) or jejunoileal bypass (JIB, n = 5) was performed in 12 women, aged 26-39 years, with severe obesity [body mass index (BMI) 46.6 +/- 2.3 kg/m(2)]. After 1 year, 75 g glucose was administered and plasma levels of glucose, insulin, GIP and GLP-1 were determined regularly during the following 2 h.
  
  
  RESULTS
  At 1 year after operation, reduction in body weight, actual body weight, fasting glucose or insulin, or the glucose and insulin responses to oral glucose did not differ significantly between the groups. Similarly, fasting GIP and GLP-1 levels did not differ significantly between the groups. In contrast, the GIP and GLP-1 responses to oral glucose were different between the groups in a dissociated pattern. Thus, AUC(GIP) was significantly higher after VBG than after JIB (53 +/- 8 vs. 26 +/- 6 pmol/l/min, p = 0.003). In contrast, AUC(GLP-1) was significantly higher after JIB than after VBG (49 +/- 5 vs. 20 +/- 3 pmol/l/min, p = 0.007).
  
  
  CONCLUSIONS
  We conclude that at 1 year after bariatric surgery, the two incretins show dissociated responses in that the GIP secretion is higher after VBG whereas GLP-1 secretion is higher after JIB. This dissociated incretin response is independent from reduction in body weight, glucose tolerance or insulin secretion.
authors.affiliation: Division of Internal Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Guldstrand
authors.forename: B
authors.initials: B
authors.lastname: Ahrén
authors.forename: E
authors.initials: E
authors.lastname: Näslund
authors.forename: J J
authors.initials: JJ
authors.lastname: Holst
authors.forename: U
authors.initials: U
authors.lastname: Adamson
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D005749:Gastric Inhibitory Polypeptide / Q000097:blood* / Q000378:metabolism; D052216:Glucagon-Like Peptide 1 / Q000097:blood* / Q000378:metabolism; D006801:Humans; D054795:Incretins / Q000097:blood*; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054795:Incretins; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1