Investigating Intestinal Glucagon After Roux-en-Y Gastric Bypass Surgery.
J Clin Endocrinol Metab
; 104(12): 6403-6416, 2019 12 01.
Article
en En
| MEDLINE
| ID: mdl-31276156
ABSTRACT
CONTEXT After Roux-en-Y gastric bypass (RYGB) surgery, postprandial plasma glucagon concentrations have been reported to increase. This occurs despite concomitant improved glucose tolerance and increased circulating plasma concentrations of insulin and the glucagon-inhibiting hormone glucagon-like peptide 1 (GLP-1). OBJECTIVE:
To investigate whether RYGB-induced hyperglucagonemia may be derived from the gut. DESIGN ANDSETTING:
Substudy of a prospective cross-sectional study at a university hospital in Copenhagen, Denmark.PARTICIPANTS:
Morbidly obese individuals undergoing RYGB (n = 8) with or without type 2 diabetes.INTERVENTIONS:
Three months before and after RYGB, participants underwent upper enteroscopy with retrieval of gastrointestinal mucosal biopsy specimens. Mixed-meal tests were performed 1 week and 3 months before and after RYGB. MAIN OUTCOMEMEASURES:
The 29-amino acid glucagon concentrations in plasma and in mucosal gastrointestinal biopsy specimens were assessed using mass spectrometry-validated immunoassays, and a new monoclonal antibody reacting with immunoreactive glucagon was used for immunohistochemistry.RESULTS:
Postprandial plasma concentrations of glucagon after RYGB were increased. Expression of the glucagon gene in the small intestine increased after surgery. Glucagon was identified in the small-intestine biopsy specimens obtained after, but not before, RYGB. Immunohistochemically, mucosal biopsy specimens from the small intestine harbored cells costained for GLP-1 and immunoreactive glucagon.CONCLUSION:
Increased concentrations of glucagon were observed in small-intestine biopsy specimens and postprandially in plasma after RYGB. The small intestine harbored cells immunohistochemically costaining for GLP-1 and glucagon-like immunoreactivity after RYGB. Glucagon derived from small-intestine enteroendocrine l cells may contribute to postprandial plasma concentrations of glucagon after RYGB.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Obesidad Mórbida
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Glucagón
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Derivación Gástrica
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Diabetes Mellitus Tipo 2
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Péptido 1 Similar al Glucagón
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Insulina
/
Intestinos
Tipo de estudio:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2019
Tipo del documento:
Article
País de afiliación:
Dinamarca