title: Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes.
abstract: BACKGROUND
  The mechanisms by which Roux-en-Y gastric bypass surgery (GBP) results in sustained weight loss and remission of type 2 diabetes are not fully understood.
  
  
  OBJECTIVE
  We hypothesized that the anorexic hormone oxyntomodulin (OXM) might contribute to the marked weight reduction and the rapid improvement in glucose metabolism observed in morbidly obese diabetic patients after GBP.
  
  
  METHODS
  Twenty obese women with type 2 diabetes were studied before and 1 month after GBP (n=10) or after a diet-induced equivalent weight loss (n=10). Patients from both groups were matched for age, body weight, body mass index, and diabetes duration and control. OXM concentrations were measured during a 50-g oral glucose challenge before and after weight loss.
  
  
  RESULTS
  At baseline, OXM levels (fasting and stimulated values) were indistinguishable between the GBP and the diet group. However, OXM levels rose remarkably in response to an oral glucose load more than 2-fold (peak, 5.25+/-1.31 to13.8+/-16.2 pmol/liter; P=0.025) after GBP but not after diet. The peak of OXM after glucose was significantly correlated with glucagon-like peptide-1 and peptide YY3-36.
  
  
  CONCLUSIONS
  Our data suggest that the observed changes in OXM primarily occur in response to GBP and not as a consequence of weight loss. These changes were observed early after surgery and occurred in parallel with previously reported increases in incretins and peptide YY. We speculate that the combination of gut hormone changes is essential for the improved glucose homeostasis and may partially explain the success of this surgery on diabetes resolution and weight loss.
authors.affiliation: Obesity Research Center, St Luke's Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA. BBL14@columbia.edu
authors.forename: Blandine
authors.initials: B
authors.lastname: Laferrère
authors.forename: Nicholas
authors.initials: N
authors.lastname: Swerdlow
authors.forename: Baani
authors.initials: B
authors.lastname: Bawa
authors.forename: Sara
authors.initials: S
authors.lastname: Arias
authors.forename: Mousumi
authors.initials: M
authors.lastname: Bose
authors.forename: Blanca
authors.initials: B
authors.lastname: Oliván
authors.forename: Julio
authors.initials: J
authors.lastname: Teixeira
authors.forename: James
authors.initials: J
authors.lastname: McGinty
authors.forename: Kristina I
authors.initials: KI
authors.lastname: Rother
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000601:surgery*; D004038:Diet, Reducing; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015390:Gastric Bypass; D005951:Glucose Tolerance Test; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism / Q000601:surgery*; D053772:Oxyntomodulin / Q000097:blood*; D011863:Radioimmunoassay; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D053772:Oxyntomodulin