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Insulin Sensitivity and β-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents.

Publication ,  Journal Article
Inge, TH; Prigeon, RL; Elder, DA; Jenkins, TM; Cohen, RM; Xanthakos, SA; Benoit, SC; Dolan, LM; Daniels, SR; D'Alessio, DA
Published in: J Pediatr
November 2015

OBJECTIVE: To test the hypothesis that insulin secretion and insulin sensitivity would be improved in adolescents after Roux-en-Y gastric bypass (RYGB). STUDY DESIGN: A longitudinal study of 22 adolescents and young adults without diabetes undergoing laparoscopic RYGB (mean age 17.1 ± 1.42 years; range 14.5-20.1; male/female 8/14; Non-Hispanic White/African American 17/5) was conducted. Intravenous glucose tolerance tests were done to obtain insulin sensitivity (insulin sensitivity index), insulin secretion (acute insulin response to glucose ), and the disposition index as primary outcome variables. These variables were compared over the 1 year of observation using linear mixed modeling. RESULTS: In the 1-year following surgery, body mass index fell by 38% from a mean of 61 ± 12.3 to 39 ± 8.0 kg/m(2) (P < .01). Over the year following surgery, fasting glucose and insulin values declined by 54% and 63%, respectively. Insulin sensitivity index increased 300% (P < .01), acute insulin response to glucose decreased 56% (P < .01), leading to a nearly 2-fold increase in the disposition index (P < .01). Consistent with improved β-cell function, the proinsulin to C-peptide ratio decreased by 21% (P < .01). CONCLUSIONS: RYGB reduced body mass index and improved both insulin sensitivity and β-cell function in severely obese teens and young adults. These findings demonstrate that RYGB is associated with marked metabolic improvements in obese young people even as significant obesity persists. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00360373.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

November 2015

Volume

167

Issue

5

Start / End Page

1042 / 8.e1

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Prospective Studies
  • Pediatrics
  • Pediatric Obesity
  • Male
  • Longitudinal Studies
  • Insulin-Secreting Cells
  • Insulin Resistance
  • Insulin
 

Citation

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Inge, T. H., Prigeon, R. L., Elder, D. A., Jenkins, T. M., Cohen, R. M., Xanthakos, S. A., … D’Alessio, D. A. (2015). Insulin Sensitivity and β-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents. J Pediatr, 167(5), 1042-8.e1. https://doi.org/10.1016/j.jpeds.2015.08.020
Inge, Thomas H., Ronald L. Prigeon, Deborah A. Elder, Todd M. Jenkins, Robert M. Cohen, Stavra A. Xanthakos, Stephen C. Benoit, Lawrence M. Dolan, Stephen R. Daniels, and David A. D’Alessio. “Insulin Sensitivity and β-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents.J Pediatr 167, no. 5 (November 2015): 1042-8.e1. https://doi.org/10.1016/j.jpeds.2015.08.020.
Inge TH, Prigeon RL, Elder DA, Jenkins TM, Cohen RM, Xanthakos SA, et al. Insulin Sensitivity and β-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents. J Pediatr. 2015 Nov;167(5):1042-8.e1.
Inge, Thomas H., et al. “Insulin Sensitivity and β-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents.J Pediatr, vol. 167, no. 5, Nov. 2015, pp. 1042-8.e1. Pubmed, doi:10.1016/j.jpeds.2015.08.020.
Inge TH, Prigeon RL, Elder DA, Jenkins TM, Cohen RM, Xanthakos SA, Benoit SC, Dolan LM, Daniels SR, D’Alessio DA. Insulin Sensitivity and β-Cell Function Improve after Gastric Bypass in Severely Obese Adolescents. J Pediatr. 2015 Nov;167(5):1042–8.e1.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

November 2015

Volume

167

Issue

5

Start / End Page

1042 / 8.e1

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Prospective Studies
  • Pediatrics
  • Pediatric Obesity
  • Male
  • Longitudinal Studies
  • Insulin-Secreting Cells
  • Insulin Resistance
  • Insulin