Effect of Laparoscopic Roux-En-Y Gastric Bypass on Metabolic Syndrome and GLP-1 Hormone
Journal Title: Journal of Medical Science And clinical Research - Year 2014, Vol 2, Issue 6
Abstract
Background: An enlarged incretin response after Roux-en-Y gastric bypass (RYGBP) has been proposed to promote weight loss and obesity-related comorbid conditions amelioration especially type 2 diabetes mellitus (T2DM). The dramatic amelioration of T2DM following RYGBP could be accounted for by changes in glucagon-like peptide-1 (GLP-1) secretion. The objective of the study is to evaluate the effect of RYGBP as a metabolic surgery on metabolic syndrome parameters and on fasting serum GLP-1 after one year in 30 patients with BMI of 35-39 Kg/m2 . This aimed to prove that a metabolic surgery should be able to resolve one or more of the metabolic syndrome parameters without causing any undue weight loss. Methods: The selected group of patients had different degrees of glucose tolerance: normal glucose tolerance (NGT, n=9), impaired glucose tolerance (IGT, n=9), and type 2 diabetes (n=12). This study was done to determine the changes of GLP-1, BMI, insulin resistance before and 1 year after RYGBP. Results: A high significant increase in serum GLP-1was recorded in the three included groups. Moreover, high significant decrease in fasting glucose from 145.3 to 99.2 mg/dl ,associated with significant decrease in fasting insulin from 16.1to11.3 µIu/liter, in all these three groups ,postoperatively, along with a high significant decrease in Homeostasis Model of Assessment - Insulin Resistance(HOMA-IR). All other metabolic syndrome components improved significantly postoperatively, including dyslipidemia, hypertension, and obesity. Conclusion: Our study supports that RYGBP is associated with alterations in glucose kinetics leading to improvement of type II DM. We consider RYGBP as a proposed treatment for type 2 diabetes.
Authors and Affiliations
Alaa Abbass Moustafa
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