Biliopancreatic diversion with duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) result in distinct post-prandial hormone profiles.,International Journal of Obesity

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Biliopancreatic diversion with duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) result in distinct post-prandial hormone profiles.
International Journal of Obesity ( IF 4.2 ) Pub Date : 2018-12-11 , DOI: 10.1038/s41366-018-0282-z
Sofia S Pereira _{1,

2} , Marta Guimarães _{1,

2,

3} , Rui Almeida ₃ , Ana M Pereira ₃ , Carolina B Lobato _{1,

2} , Bolette Hartmann ₄ , Linda Hilsted ₅ , Jens J Holst ₄ , Mário Nora _{1,

3} , Mariana P Monteiro _{1,

2}

Affiliation

BACKGROUND/OBJECTIVE Biliopancreatic diversion with duodenal switch (BPD-DS) is the most effective bariatric intervention to treat morbid obesity and related disorders. Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a new bariatric procedure devised with the purpose of simplifying the complexity of the BPD-DS technique while maintaining its efficacy. However, whether BPD-DS and SADI-S result in similar fasting and post-prandial hormone profiles has not yet been studied. Therefore, the purpose of this study was to assess and compare the hormone response to a standardized mixed meal in subjects operated with BPD-DS or SADI-S. SUBJECTS/METHODS Subjects submitted to BPD-DS (n = 9) or SADI-S (n = 9) 1.5 years earlier on average, with no past nor current diabetes diagnosis underwent a liquid mixed-meal tolerance test (MMTT) to assess the baseline and post-prandial profile of glucose, enteropancreatic hormones and total bile acids. RESULTS Fasting glucose, enteropancreatic hormones and total bile acids levels after BPD-DS and SADI-S were similar. After the MMTT, the response of subjects who underwent SADI-S was characterized by higher glucose (t = 30 min: p < 0.05; iAUC: 156.1 ± 46.2 vs. 103.4 ± 35.8 mmol/L × min, p = 0.02), GLP-1 (t = 30 min: p < 0.05; iAUC: 5388 ± 3010 vs. 2959.0 ± 2146 pmol/L × min, p = 0.02), glucagon (t = 30 min: p < 0.05; iAUC: 678.7 ± 295.2 vs. 376.9 ± 215.7 pmol/L × min, p = 0.02), insulin (t = 30 and 45 min: p < 0.05); and C-peptide levels (t = 30 and 45 min: p < 0.05), when compared to BPD-DS. CONCLUSIONS The post-prandial hormone secretion profile after SADI-S is characterized by increased GLP-1, glucagon and insulin secretion, when compared to BPD-DS, which suggests the existence of different endocrine driven mechanisms leading to weight loss and metabolic improvement after the two procedures.

中文翻译：

十二指肠开关胆胰分流术（BPD-DS）和单吻合十二指肠-回肠旁路袖状胃切除术（SADI-S）导致不同的餐后激素分布。

背景/目的十二指肠开关胆胰分流术 (BPD-DS) 是治疗病态肥胖和相关疾病的最有效的减肥干预措施。单吻合十二指肠-回肠搭桥袖状胃切除术 (SADI-S) 是一种新的减肥手术，旨在简化 BPD-DS 技术的复杂性，同时保持其疗效。然而，尚未研究 BPD-DS 和 SADI-S 是否会导致相似的空腹和餐后激素谱。因此，本研究的目的是评估和比较接受 BPD-DS 或 SADI-S 手术的受试者对标准化混合膳食的激素反应。受试者/方法受试者平均提前 1.5 年提交 BPD-DS (n = 9) 或 SADI-S (n = 9)，既往无糖尿病诊断的患者接受了液体混合膳食耐受试验 (MMTT)，以评估葡萄糖、肠胰激素和总胆汁酸的基线和餐后情况。结果 BPD-DS 和 SADI-S 后的空腹血糖、肠胰激素和总胆汁酸水平相似。在 MMTT 之后，接受 SADI-S 的受试者的反应以更高的葡萄糖为特征（t = 30 分钟：p < 0.05；iAUC：156.1 ± 46.2 vs. 103.4 ± 35.8 mmol/L × min，p = 0.02），GLP -1（t = 30 分钟：p < 0.05；iAUC：5388 ± 3010 对比 2959.0 ± 2146 pmol/L × min，p = 0.02），胰高血糖素（t = 30 分钟：p < 0.05；iAUC：678.7 ± 295.2 对比. 376.9 ± 215.7 pmol/L × min, p = 0.02)，胰岛素（t = 30 和 45 分钟：p < 0.05）；与 BPD-DS 相比，C 肽水平（t = 30 和 45 分钟：p < 0.05）。

更新日期：2019-01-26

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