Effect of bariatric surgery on liver glucose metabolism in morbidly obese diabetic and non-diabetic patients

Heidi Immonen, Jarna C. Hannukainen, Patricia Iozzo, Minna Soinio, Paulina Salminen, Virva Saunavaara, Ronald Borra, Riitta Parkkola, Andrea Mari, Terho Lehtimaki, Tam Pham, Jukka Laine, Vesa Karja, Jussi Pihlajamaki, Lassi Nelimarkka, Pirjo Nuutila*

*Corresponding author voor dit werk

    OnderzoeksoutputAcademicpeer review

    87 Citaten (Scopus)

    Samenvatting

    Background & Aims: Bariatric surgery reduces weight and improves glucose metabolism in obese patients. We investigated the effects of bariatric surgery on hepatic insulin sensitivity.

    Methods: Twenty-three morbidly obese (nine diabetic and fourteen non-diabetic) patients and ten healthy, lean control subjects were studied using positron emission tomography to assess hepatic glucose uptake in the fasting state and during euglycemic hyperinsulinemia. Magnetic resonance spectroscopy was performed to measure liver fat content and magnetic resonance imaging to obtain liver volume. Obese patients were studied before bariatric surgery (either sleeve gastrectomy or Roux-en-Y gastric bypass) and six months after surgery.

    Results: Insulin-induced hepatic glucose uptake was increased by 33% in non-diabetic and by 36% in diabetic patients at follow-up compared with baseline, but not totally normalized. The liver fat content was reduced by 76%, liver volume by 26% and endogenous glucose production by 19% in non-diabetic patients. The respective changes in diabetic patients were 73%, 24%, and 25%. Postoperatively, liver fat content and endogenous glucose production were almost normalized to lean controls, but liver volume remained greater than in control subjects.

    Conclusions: This study shows that bariatric surgery leads to a significant improvement in hepatic insulin sensitivity: insulin-stimulated hepatic glucose uptake was improved and endogenous glucose production reduced when measured, six-months, after surgery. These metabolic effects were accompanied by a marked reduction in hepatic volume and fat content. Overall, the gain in hepatic insulin sensitivity in diabetic patients was quite similar to non-diabetic patients for the same weight reduction. (C) 2013 Published by Elsevier B.V. on behalf of the European Association for the Study of the Liver.

    Originele taal-2English
    Pagina's (van-tot)377-383
    Aantal pagina's7
    TijdschriftJournal of Hepatology
    Volume60
    Nummer van het tijdschrift2
    DOI's
    StatusPublished - feb.-2014

    Vingerafdruk

    Duik in de onderzoeksthema's van 'Effect of bariatric surgery on liver glucose metabolism in morbidly obese diabetic and non-diabetic patients'. Samen vormen ze een unieke vingerafdruk.

    Citeer dit