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Muscle insulin receptor concentrations in obese patients post bariatric surgery: relationship to hyperinsulinemia

International Journal of Obesity volume 28, pages 363–369 (2004)Cite this article

Abstract

OBJECTIVE: Obesity results in insulin resistance. Bariatric surgery for obese individuals induces weight loss, improves insulin sensitivity, and lowers insulin levels. We investigated the mechanisms of this improvement.

DESIGN: Insulin receptor (IR) content, IR signaling, and adiponectin levels were measured in nine morbidly obese subjects before and after bariatric surgery.

SUBJECTS: Seven female and two male, average age 44±2y, BMI >40 kg/m2 and/or at least 100 lbs over ideal body weight, undergoing elective bariatric surgery.

MEASUREMENTS: Before surgery BMI, fasting plasma glucose, adiponectin, and insulin levels were measured. A fasting muscle biopsy was obtained from the vastus lateralis for IR concentration and autophosphorylation activity measurements. These procedures were repeated 1 y after surgery.

RESULTS: At 1 y after surgery, the subjects had lost an average of 48.3±5.6 kg (P<0.001), insulin sensitivity had significantly increased as determined by the minimal model (SI 0.72±0.18 vs 3.86±1.43, P<0.05), and IR content had increased two-fold in muscle (2.1±0.4 vs 4.3±0.7 ng/mg protein, P<0.01). The increase in IR content was related to fasting insulin levels. In the subjects with the lowest IR function, there was also an increase in IR function. Plasma adiponectin increased by 40% following weight loss (7.4±1.6 pre vs 10.3±1.3 mg/ml post, P<0.05). There was no significant change in muscle content of the IR inhibitor, PC-1.

CONCLUSION: Increased IR content, most likely regulated by insulin levels, may be one contributor to the increased insulin sensitivity that occurs when morbidly obese patients undergo bariatric surgery.

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Acknowledgements

This work was supported by grants from the American Diabetes Association and the American Physiological Society. We would also like to express our gratitude for the technical assistance of Kimber Stanhope in conducting the adiponectin assay.

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Authors and Affiliations

  1. Department of Medicine, Division of Diabetes and Endocrine Research, Mount Zion Medical Center, University of California, San Francisco, San Francisco, CA, USA

    C Pender, I D Goldfine & J F Youngren

  2. Department of Exercise and Sport Science, Human Performance Laboratory, East Carolina University, Greenville, NC, USA

    C J Tanner & J A Houmard

  3. Department of Surgery, East Carolina University, Greenville, NC, USA

    W J Pories & K G MacDonald

  4. Department of Nutrition, University of California Davis, 1 Shields Ave, Davis, 95616, CA, USA

    P J Havel

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  1. C Pender
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Correspondence to J F Youngren.

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Pender, C., Goldfine, I., Tanner, C. et al. Muscle insulin receptor concentrations in obese patients post bariatric surgery: relationship to hyperinsulinemia. Int J Obes 28, 363–369 (2004). https://doi.org/10.1038/sj.ijo.0802565

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