Morbidly Obese Individuals with Impaired Fasting Glucose have a Specific Pattern of Insulin Secretion and Sensitivity: Effect of Weight Loss after Bariatric Surgery (original) (raw)

Background: Obesity is often associated with hyper-secrection of insulin. Impaired fasting glucose (IFG) has recently been redefined as a fasting plasma glucose of 5.6-6.9 mmol/L. The aim of this study was to determine whether changes in insulin secretion in morbidly obese persons also commence with normal serum glucose levels. Methods: 32 morbidly obese subjects were studied before and after bariatric surgery. Measurements were made of glucose tolerance (KG), insulin sensitivity (SI), first-phase insulin release and the disposition index (DI) from a frequently sampled intravenous glucose tolerance test. Result: In morbidly obese subjects, the SI (P<0.01), DI (P<0.01) and first-phase insulin release (P<0.02) started changing with serum glucose levels considered to be normal (5.00-5.28 mmol/L). KG showed a clear slope according to the baseline glycemia status (P<0.05), and it was significantly related with the DI, both before (r=0.76, P<0.001) and after (r=0.57, _P_=0.002) surgery. Following surgery, all the variables significantly associated with insulin secretion and insulin sensitivity recovered significantly. The most significant changes occurred in morbidly obese individuals with IFG. Conclusions: Morbidly obese subjects show slopes of insulin sensitivity and insulin secretion in accordance with their baseline serum glucose levels. The fall in first-phase insulin release begins when serum glucose values are considered normal. Morbidly obese persons with the IFG phenotype have a specific pattern of insulin sensitivity and insulin secretion. KG clearly discriminates the clinical phenotypes, depending on baseline serum glucose levels.

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Authors and Affiliations

1. Fundación IMABIS, Málaga, Spain
   Eduardo García-Fuentes
2. Servicio de Endocrinología y Nutrición, Hospital Clínico Virgen de la Victoria, Málaga, Spain
   Jose Manuel García-Almeida
3. Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain
   Juan García-Arnés
4. Servicio de Cirugía General, Hospital Clínico Virgen de la Victoria, Málaga, Spain
   Jose Rivas-Marín
5. Servicio de Cirugía General, Hospital Regional Universitario Carlos Haya, Málaga, Spain
   Jose Luis Gallego-Perales
6. Servicio de Psicología Clínica, Hospital Clínico Virgen de la Victoria, Málaga, Spain
   Belén González-Jiménez
7. Fundación IMABIS, Málaga, Spain
   Isabel Cardona
8. Fundación IMABIS, Málaga, Spain
   Sara García-Serrano
9. Servicio de Análisis Clínicos, Hospital Regional Universitario Carlos Haya, Málaga, Spain
   M José Garriga
10. Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain
    Montserrat Gonzalo
11. Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain
    M Sol Ruiz de Adana
12. Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain
    Federico Soriguer

Authors

1. Eduardo García-Fuentes
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2. Jose Manuel García-Almeida
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3. Juan García-Arnés
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4. Jose Rivas-Marín
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5. Jose Luis Gallego-Perales
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6. Belén González-Jiménez
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7. Isabel Cardona
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8. Sara García-Serrano
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9. M José Garriga
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10. Montserrat Gonzalo
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11. M Sol Ruiz de Adana
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12. Federico Soriguer
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García-Fuentes, E., García-Almeida, J.M., García-Arnés, J. et al. Morbidly Obese Individuals with Impaired Fasting Glucose have a Specific Pattern of Insulin Secretion and Sensitivity: Effect of Weight Loss after Bariatric Surgery.OBES SURG 16, 1179–1188 (2006). https://doi.org/10.1381/096089206778392383

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• Published: 01 September 2006
• Issue Date: September 2006
• DOI: https://doi.org/10.1381/096089206778392383