title: Postprandial GLP-2 Levels Are Increased After Biliopancreatic Diversion in Diabetic Individuals with Class I Obesity: a Prospective Study.
abstract: Biliopancreatic diversion (BPD) is a predominantly malabsorptive procedure. Glucagon-like peptide 2 (GLP-2) plays predominantly trophic effects on the gut. A significant increase in GLP-2 after BPD in rats was previously observed, but there are no studies investigating the effect of BPD in GLP-2 levels in humans.
  
  
  
  The aim of this study is to evaluate the influence of BPD on the release of GLP-2.
  
  
  
  This is a prospective cohort study that evaluated diabetic individuals with class I obesity which underwent BPD (Scopinaro operation) and were followed up for 12 months. Of 12 individuals, four did not comply with the proposed follow-up and were excluded from the analysis. GLP-2 levels were determined by means of an enzyme-linked immunosorbent assay (ELISA), and we collected serial lab samples through a standard meal tolerance test (MTT) in the immediate preoperative period and 12 months after surgery.
  
  
  
  During standard MTT, we observed significant increases of GLP-2 levels from 15 to 60 min (respectively, at 15 min, 5.7 ± 3.4 versus 12.4 ± 4.3, p = 0.029; 30 min, 6 ± 3.5 versus 14.6 ± 3.9; p = 0.004; 45 min, 5.6 ± 4.1 versus 12.6 ± 5.2, p = 0.013; 60 min, 5.8 ± 2.9 versus 10.6 ± 5.6, p = 0.022); then it began to gradually decrease to levels close to the basal.
  
  
  
  Our findings have confirmed that there is a significant increase in GLP-2 levels after BPD in humans. GLP-2 plays a number of roles which may be adaptive, compensatory, and beneficial in the context of BPD. The clinical implications of this finding remain to be completely understood.
authors.affiliation: Department of Surgery; Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil. notrevezzo@yahoo.com.br.
authors.forename: Everton
authors.identifier: 0000-0002-5804-1580
authors.initials: E
authors.lastname: Cazzo
authors.affiliation: Department of Surgery; Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Pareja
authors.affiliation: Research Laboratory of Metabolism and Diabetes (LIMED), Gastrocentro, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Geloneze
authors.affiliation: Department of Surgery; Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil.
authors.forename: Elinton Adami
authors.initials: EA
authors.lastname: Chaim
authors.affiliation: Department of Surgery; Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil.
authors.forename: Maria Rita Lazzarini
authors.initials: MRL
authors.lastname: Barreto
authors.affiliation: Department of Surgery; Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil.
authors.forename: Daniéla Oliveira
authors.initials: DO
authors.lastname: Magro
mesh_terms: D000328:Adult; D000818:Animals; D015904:Biliopancreatic Diversion; D048909:Diabetes Complications / Q000601:surgery; D003920:Diabetes Mellitus / Q000601:surgery*; D005260:Female; D052216:Glucagon-Like Peptide 1; D053767:Glucagon-Like Peptide 2 / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000601:surgery*; D019518:Postprandial Period; D011446:Prospective Studies; D051381:Rats
chemical_list: D053767:Glucagon-Like Peptide 2; D052216:Glucagon-Like Peptide 1
keywords: Bariatric surgery; Biliopancreatic diversion; Diabetes mellitus; Glucagon-like peptide 2; Glucagon-like peptides; Obesity