Abstract
OBJECTIVE: To examine the impact of important weight loss on insulin inhibition of its own secretion during experimentally induced hyperinsulinemia under euglycemic conditions.
DESIGN: Longitudinal, clinical intervention study—bariatric surgery (vertical banded gastroplasty—gastric bypass—Capella technique), re-evaluation after 4 and 14 months.
SUBJECTS: Nine obese patients class III (BMI=54.6±2.6 kg/m2) and nine lean subjects (BMI=22.7±0.7 kg/m2).
MEASUREMENTS: Euglycemic hyperinsulinemic clamp (insulin infusion: 40 mU/min m2), C-peptide plasma levels, electrical bioimpedance methodology, and oral glucose tolerance test (OGTT).
RESULTS: BMI was reduced in the follow-up: 44.5±2.2 and 33.9±1.5 kg/m2 at 4 and 14 months. Insulin-induced glucose uptake was markedly reduced in obese patients (19.5±1.9 μmol/min kg FFM) and improved with weight loss, but in the third study, it was still lower than that observed in controls (35.9±4.0 vs 52.9±2.2 μmol/min kg FFM). Insulin-induced inhibition of its own secretion was blunted in obese patients (19.9±5.7%, relative to fasting values), and completely reversed to values similar to that of lean ones in the second and third studies (−60.8±4.2 and −54.0±6.1%, respectively).
CONCLUSION: Weight loss in severe obesity improved insulin-induced glucose uptake, and completely normalized the insulin inhibition on its own secretion.
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Financial support from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) and Fundação de Apoio ao Ensino e Pesquisa (FAEP, UNICAMP) is acknowledged.
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Pereira, J., Claro, B., Pareja, J. et al. Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery. Int J Obes 27, 463–468 (2003). https://doi.org/10.1038/sj.ijo.0802269
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DOI: https://doi.org/10.1038/sj.ijo.0802269
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