title: Matched weight loss induced by sleeve gastrectomy or gastric bypass similarly improves metabolic function in obese subjects.
abstract: OBJECTIVE
  The effects of marked weight loss, induced by Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgeries, on insulin sensitivity, β-cell function and the metabolic response to a mixed meal were evaluated.
  
  
  METHODS
  Fourteen nondiabetic insulin-resistant patients who were scheduled to undergo SG (n = 7) or RYGB (n = 7) procedures completed a hyperinsulinemic-euglycemic clamp procedure and a mixed-meal tolerance test before surgery and after losing ∼20% of their initial body weight.
  
  
  RESULTS
  Insulin sensitivity (insulin-stimulated glucose disposal during a clamp procedure), oral glucose tolerance (postprandial plasma glucose area under the curve), and β-cell function (insulin secretion in relationship to insulin sensitivity) improved after weight loss, and were not different between surgical groups. The metabolic response to meal ingestion was similar after RYGB or SG, manifested by rapid delivery of ingested glucose into the systemic circulation and a large early postprandial increase in plasma glucose, insulin, and C-peptide concentrations in both groups.
  
  
  CONCLUSIONS
  When matched on weight loss, RYGB and SG surgeries result in similar improvements in the two major factors involved in regulating plasma glucose homeostasis, insulin sensitivity and β-cell function in obese people without diabetes.
authors.affiliation: Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St. Louis, Missouri, USA; Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Medical Center, Columbus, Ohio, USA.
authors.forename: David
authors.initials: D
authors.lastname: Bradley
authors.forename: Faidon
authors.initials: F
authors.lastname: Magkos
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Eagon
authors.forename: J Esteban
authors.initials: JE
authors.lastname: Varela
authors.forename: Amalia
authors.initials: A
authors.lastname: Gastaldelli
authors.forename: Adewole L
authors.initials: AL
authors.lastname: Okunade
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Patterson
authors.forename: Samuel
authors.initials: S
authors.lastname: Klein
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism* / Q000601:surgery*; D019518:Postprandial Period; D015431:Weight Loss / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin