Effects of different metabolic states and surgical models on glucose metabolism and secretion of ileal L-cell peptides: protocol for a cross-sectional study

Alper Celik, John B Dixon, Sjaak Pouwels, Bahri Onur Celik, Fatih Can Karaca, Adarsh Gupta, Sergio Santoro, Surendra Ugale, Alper Celik, John B Dixon, Sjaak Pouwels, Bahri Onur Celik, Fatih Can Karaca, Adarsh Gupta, Sergio Santoro, Surendra Ugale

Abstract

Introduction: Obesity and type 2 diabetes mellitus are increasing worldwide, reaching pandemic proportions. The understanding of the role of functional restriction and gut hormones can be a beneficial tool in treating obesity and diabetes. However, the exact hormonal profiles in different metabolic states and surgical models are not known.

Methods and analysis: The HIPER-1 Study is a single-centre cross-sectional study in which 240 patients (in different metabolic states and surgical models) will receive an oral mixed-meal tolerance test (OMTT). At baseline and after 30, 60 and 120 min, peptide YY and glucagon-like peptide 1 levels and glucose and insulin sensitivity will be measured. The primary end point of the study will be the area under the glucagon-like peptide 1 and peptide YY curves after the OMTT. Secondary study end points will include examination of the difference in plasma levels of the distal ileal hormones in subjects with various health statuses and in patients who have been treated with different surgical techniques.

Ethics and dissemination: An independent ethics committee, the Institutional Review Board of Istanbul Sisli Kolan International Hospital, Turkey, has approved the study protocol. Dissemination will occur via publication, national and international conference presentations, and exchanges with regional, provincial and national stakeholders.

Trial registration number: NCT02532829; Pre-results.

Keywords: Metabolic surgery; bariatric surgery; glucose metabolism; ileal L-cell peptides.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

References

    1. American Diabetes Association. The dangerous toll of diabetes.
    1. Vaag AA. Glycemic control and prevention of microvascular and macrovascular disease in the Steno 2 study. Endocr Pract 2006;12(Suppl 1):89–92. 10.4158/EP.12.S1.89
    1. Gerstein HC, Miller ME, Byington RP et al. . Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008;358:2545–59. 10.1056/NEJMoa0802743
    1. Choudhury SR, Datta A, Chanda S et al. . Overview of current and upcoming strategies implied for the therapy of type 2 diabetes mellitus. Curr Diabetes Rev 2014;10:275–82. 10.2174/1573399810666140825154815
    1. Domecq JP, Prutsky G, Leppin A et al. . Clinical review: drugs commonly associated with weight change: a systematic review and meta-analysis. J Clin Endocrinol Metab 2015;100: 363–70. 10.1210/jc.2014-3421
    1. Bermudez DM, Pories WJ. New technologies for treating obesity. Minerva Endocrinol 2013;38:165–72.
    1. Buchwald H, Estok R, Fahrbach K et al. . Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med 2009;122:248–56.e5. 10.1016/j.amjmed.2008.09.041
    1. Schauer PR, Kashyap SR, Wolski K et al. . Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012;366:1567–76. 10.1056/NEJMoa1200225
    1. Vetter ML, Cardillo S, Rickels MR et al. . Narrative review: effect of bariatric surgery on type 2 diabetes mellitus. Ann Intern Med 2009;150:94–103. 10.7326/0003-4819-150-2-200901200-00007
    1. DePaula AL, Macedo AL, Schraibman V et al. . Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus patients with BMI 20-34. Surg Endosc 2009;23:1724–32. 10.1007/s00464-008-0168-6
    1. Kashyap SR, Daud S, Kelly KR et al. . Acute effects of gastric bypass versus gastric restrictive surgery on beta-cell function and insulinotropic hormones in severely obese patients with type 2 diabetes. Int J Obes (Lond) 2010;34:462–71. 10.1038/ijo.2009.254
    1. Finelli C, Padula MC, Martelli G et al. . Could the improvement of obesity-related co-morbidities depend on modified gut hormones secretion? World J Gastroenterol 2014;20:16649–64. 10.3748/wjg.v20.i44.16649
    1. Goldfine AB, Mun EC, Devine E et al. . Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab 2007;92:4678–85. 10.1210/jc.2007-0918
    1. Kashyap SR, Bhatt DL, Wolski K et al. . Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment. Diabetes Care 2013;36:2175–82. 10.2337/dc12-1596
    1. Troke RC, Tan TM, Bloom SR. The future role of gut hormones in the treatment of obesity. Ther Adv Chronic Dis 2014;5:4–14. 10.1177/2040622313506730
    1. Essah PA, Levy JR, Sistrun SN et al. . Effect of weight loss by a low-fat diet and a low-carbohydrate diet on peptide YY levels. Int J Obes (Lond) 2010;34:1239–42. 10.1038/ijo.2010.48
    1. Batterham RL, Cowley MA, Small CJ et al. . Gut hormone PYY(3-36) physiologically inhibits food intake. Nature 2002;418:650–4. 10.1038/nature02666
    1. Batterham RL, Cohen MA, Ellis SM et al. . Inhibition of food intake in obese subjects by peptide YY3-36. N Engl J Med 2003;349:941–8. 10.1056/NEJMoa030204
    1. Celik A, Ugale S. Functional restriction and a new balance between proximal and distal gut: the tools of the real metabolic surgery. Obes Surg 2014;24:1742–3. 10.1007/s11695-014-1368-x
    1. Celik A, Ugale S, Ofluoglu H et al. . Metabolic outcomes of laparoscopic diverted sleeve gastrectomy with ileal transposition (DSIT) in obese type 2 diabetic patients. Obes Surg 2015;25:2018–22.
    1. Santoro S. From bariatric to pure metabolic surgery: new concepts on the rise. Ann Surg 2015;262:e79–80. 10.1097/SLA.0000000000000590
    1. Vilsbøll T, Krarup T, Sonne J et al. . Incretin secretion in relation to meal size and body weight in healthy subjects and people with type 1 and type 2 diabetes mellitus. J Clin Endocrinol Metab 2003;88:2706–13. 10.1210/jc.2002-021873
    1. Deschamps I, Heptner W, Desjeux J-F et al. . Effects of diet on insulin and gastric inhibitory polypeptide levels in obese children. Pediatr Res 1980;14(Pt 1):300–3. 10.1203/00006450-198004000-00008
    1. Miyawaki K, Yamada Y, Ban N et al. . Inhibition of gastric inhibitory polypeptide signaling prevents obesity. Nat Med 2002;8:738–42. 10.1038/nm727
    1. Irwin N, Flatt PR. Evidence for beneficial effects of compromised gastric inhibitory polypeptide action in obesity-related diabetes and possible therapeutic implications. Diabetologia 2009;52:1724–31. 10.1007/s00125-009-1422-8

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다