Sleeve gastrectomy rapidly enhances islet function independently of body weight.
JCI Insight
; 4(6)2019 03 21.
Article
in En
| MEDLINE
| ID: mdl-30777938
ABSTRACT
Bariatric surgeries including vertical sleeve gastrectomy (VSG) ameliorate obesity and diabetes. Weight loss and accompanying increases to insulin sensitivity contribute to improved glycemia after surgery; however, studies in humans also suggest weight-independent actions of bariatric procedures to lower blood glucose, possibly by improving insulin secretion. To evaluate this hypothesis, we compared VSG-operated mice with pair-fed, sham-surgical controls (PF-Sham) 2 weeks after surgery. This paradigm yielded similar postoperative body weight and insulin sensitivity between VSG and calorically restricted PF-Sham animals. However, VSG improved glucose tolerance and markedly enhanced insulin secretion during oral nutrient and i.p. glucose challenges compared with controls. Islets from VSG mice displayed a unique transcriptional signature enriched for genes involved in Ca2+ signaling and insulin secretion pathways. This finding suggests that bariatric surgery leads to intrinsic changes within the islet that alter function. Indeed, islets isolated from VSG mice had increased glucose-stimulated insulin secretion and a left-shifted glucose sensitivity curve compared with islets from PF-Sham mice. Isolated islets from VSG animals showed corresponding increases in the pulse duration of glucose-stimulated Ca2+ oscillations. Together, these findings demonstrate a weight-independent improvement in glycemic control following VSG, which is, in part, driven by improved insulin secretion and associated with substantial changes in islet gene expression. These results support a model in which ß cells play a key role in the adaptation to bariatric surgery and the improved glucose tolerance that is typical of these procedures.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Body Weight
/
Insulin-Secreting Cells
/
Bariatric Surgery
/
Insulin Secretion
/
Gastrectomy
Type of study:
Prognostic_studies
Limits:
Animals
/
Humans
Language:
En
Journal:
JCI Insight
Year:
2019
Document type:
Article
Affiliation country: