Ghrelin suppression is associated with weight loss and insulin action following gastric bypass surgery at 12 months in obese adults with type 2 diabetes

• Published in: Diabetes, obesity & metabolism Vol. 15; no. 10; pp. 963 - 966
• Main Authors: Samat, A., Malin, S. K., Huang, H., Schauer, P. R., Kirwan, J. P., Kashyap, S. R.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2013
• Subjects: Adult; Blood Glucose - metabolism; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - surgery; Female; Gastric Bypass; Ghrelin - blood; glycaemic control; Glycemic Index; gut hormones; Humans; Insulin - metabolism; insulin action; Insulin Resistance; Male; Obesity, Morbid - blood; Obesity, Morbid - physiopathology; Obesity, Morbid - surgery; Remission Induction; Time Factors; Treatment Outcome; Weight Loss; insulin action; weight loss; glycaemic control; gut hormones
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.12118

Roux‐en‐Y gastric bypass (RYGB) surgery reverses type 2 diabetes mellitus (T2DM) in approximately 80% of patients. Ghrelin regulates glucose homeostasis, but its role in T2DM remission after RYGB surgery is unclear. Nine obese T2DM subjects underwent a mixed meal tolerance test before and at 1 and 12 months after RYGB surgery. Changes in ghrelin, body weight, glucagon‐like polypeptide‐1 (GLP‐1, glucose tolerance and insulin sensitivity (IS) were measured. At 1 month, body weight, glycaemia and IS were improved, while ghrelin concentrations were reduced (p < 0.05). After 12 months, body weight and fasting glucose were reduced (30 and 16%, respectively; p < 0.05) and IS was enhanced (threefold; p < 0.05). Ghrelin suppression improved by 32% at 12 months (p < 0.05), and this was associated with weight loss (r = 0.72, p = 0.03), enhanced IS (r = −0.78, p = 0.01) and peak postprandial GLP‐1 (r = −0.73, p = 0.03). These data suggest that postprandial ghrelin suppression may be part of the mechanism that contributes to diabetes remission after RYGB surgery.