GLP-1 and peptide YY secretory response after fat load is impaired by insulin resistance, impaired fasting glucose and type 2 diabetes in morbidly obese subjects.

Abstract

OBJECTIVE:

Both glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) are gut hormones involved in energy homoeostasis. Obesity, insulin resistance and hyperglycaemia are significant confounders when GLP-1 and PYY secretion is assessed. Thus, we evaluated GLP-1 and PYY response after fat load in morbidly obese patients with different degrees of insulin resistance and glycemic status.

DESIGN:

We studied 40 morbidly obese subjects (mean age, 40·6 ± 1·3 years; mean BMI, 53·1 ± 1·2 kg/m(2) ) divided into groups according to their glycemic status: normal fasting glucose (NFG) group, impaired fasting glucose (IFG) group and type 2 diabetes mellitus (T2D) group. NFG patients were additionally subclassified, according to the homoeostasis model assessment of insulin resistance (HOMAIR ), into a low insulin-resistance (LIR) group (HOMAIR <3·9) or a high insulin-resistance (HIR) group (HOMAIR ≥3·9).

MEASUREMENTS:

Lipid emulsion was administered orally and measurements made at baseline and 180 min postprandially of levels of GLP-1, PYY, insulin, glucose, free fatty acids, triglycerides and leptin.

RESULTS:

At the 180-minute postprandial reading, GLP-1 and PYY had increased in LIR-NFG subjects (41·84%, P = 0·01; 35·7%, P = 0·05; respectively), whereas no changes were observed in HIR-NFG, IFG or T2D subjects.

CONCLUSIONS:

These results suggest that in morbidly obese subjects, both insulin resistance and abnormal glucose metabolism (IFG or T2D) impair the GLP-1 and PYY response to fat load. The implications of this attenuated enteroendocrine response should be elucidated by further studies.

• Authors: José C Fernández-García, Mora Murri, Leticia Coin-Aragüez, Juan Alcaide, Rajaa El Bekay, Francisco J Tinahones
• Journal: Clinical endocrinology (Clin Endocrinol (Oxf)) Vol. 80 Issue 5 Pg. 671-6 (May 2014) ISSN: 1365-2265 [Electronic] England
• PMID: 23573808 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 John Wiley & Sons Ltd.

Chemical References

• Blood Glucose
• Lipids
• Peptide YY
• Glucagon-Like Peptide 1

Topics

• Adult
• Blood Glucose (analysis)
• Body Mass Index
• Diabetes Mellitus, Type 2 (blood)
• Fasting
• Female
• Glucagon-Like Peptide 1 (blood)
• Homeostasis
• Humans
• Insulin Resistance
• Lipids (administration & dosage)
• Male
• Middle Aged
• Obesity, Morbid (blood)
• Peptide YY (blood)