Gastric bypass and banding equally improve insulin sensitivity and β cell function
Open accessAbstract
Bariatric surgery in obese patients is a highly effective method of preventing or resolving type 2 diabetes mellitus (T2DM); however, the remission rate is not the same among different surgical procedures.We compared the effects of 20% weight loss induced by laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass (RYGB) surgery on the metabolic response to a mixed meal, insulin sensitivity, and β cell function in nondiabetic obese adults.The metabolic response to meal ingestion was markedly different after RYGB than after LAGB surgery, manifested by rapid delivery of ingested glucose into the systemic circulation, by an increase in the dynamic insulin secretion rate, and by large, early postprandial increases in plasma glucose, insulin, and glucagon-like peptide-1 concentrations in the RYGB group.However, the improvement in oral glucose tolerance, insulin sensitivity, and overall β cell function after weight loss were not different between surgical groups.Additionally, both surgical procedures resulted in a similar decrease in adipose tissue markers of inflammation.We conclude that marked weight loss itself is primarily responsible for the therapeutic effects of RYGB and LAGB on insulin sensitivity, β cell function, and oral glucose tolerance in nondiabetic obese adults. Insulin sensitivityValues for insulin sensitivity, assessed by using the homeostasis model assessment of insulin resistance (HOMA-IR), decreased by more than half after weight loss in the LAGB and RYGB groups, but Conflict of interest: Samuel Klein serves on a Scientific Advisory Board for Ethicon Endo-Surgery.
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Self-citation
- Authors
- Bradley, D., Conte, C., Mittendorfer, B., Eagon, J. C., Varela, J. E., Fabbrini, E., Gastaldelli, A., Chambers, K. T., Su, X., Okunade, A., Patterson, B. W., & Klein, S.
- Affiliations
- Washington University in St. Louis (US)
- Istituto di Fisiologia Clinica (IT)
- Corresponding author
- Klein, Samuel
- ORCID
- Venue
- Journal of Clinical Investigation
- Published
- 2012-11-26
- Volume
- 122
- Issue
- 12
- Pages
- 4667-4674
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC3512168
- OpenAlex
- W2137554096
- Cited by
- 244
- References
- 44
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 11 · 2021: 16 · 2020: 11 · 2019: 18 · 2018: 18 · 2017: 25 · 2016: 22 · 2015: 34 · 2014: 33 · 2013: 31
- FWCI
- 32.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons@Becker (Washington University School of Medicine) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Funders
- National Institutes of Health (5p41rr000954-34, UL1TR000448, DK56341, RR024992)
- National Heart, Lung, and Blood Institute (T32HL007456)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK37948, DK56341, R01DK037948, P30DK056341, P30DK020579)
- National Center for Research Resources (P41-RR000954, RR 00954, UL1RR024992)
- Ethicon Endo-Surgery
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- bariatric surgery, Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, insulin sensitivity, beta-cell function, type 2 diabetes remission, obesity, weight loss, oral glucose tolerance, glucagon-like peptide-1, adipose tissue inflammation, insulin resistance
- MeSH terms
- Insulin Secretion, Adult, Body Composition, Calcium-Binding Proteins, Ceramides, Diglycerides, Female, Humans, Insulin, Insulin Resistance, Male, Membrane Glycoproteins, Middle Aged, Mucins, Obesity, Organ Size, Gastric Bypass, Gastroplasty, Weight Loss, Cytokines, Muscle, Skeletal, Inflammation Mediators, Postprandial Period, Area Under Curve, CD11b Antigen, Receptors, G-Protein-Coupled, Intra-Abdominal Fat, Insulin-Secreting Cells
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