The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy
To determine the normalization of postprandial blood glucose (PG) and triglyceride (TG) excursions in 30 morbidly obese patients with or without diabetes mellitus (DM) 1-year after they underwent a laparoscopic sleeve gastrectomy (LSG) vs. their pre-surgery data, we administered the 75-g oral glucos...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japan Endocrine Society
2023-12-01
|
| Series: | Endocrine Journal |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/70/12/70_EJ23-0241/_html/-char/en |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832591696509009920 |
|---|---|
| author | Yukako Yamamoto Takeshi Togawa Osamu Sekine Yuki Ozamoto Junko Fuse Choka Azuma Jun Ito-Kobayashi Yasumitsu Oe Akeo Hagiwara Masaki Kobayashi Tadahiro Kitamura Masanori Iwanishi Akira Shimatsu Atsunori Kashiwagi |
| author_facet | Yukako Yamamoto Takeshi Togawa Osamu Sekine Yuki Ozamoto Junko Fuse Choka Azuma Jun Ito-Kobayashi Yasumitsu Oe Akeo Hagiwara Masaki Kobayashi Tadahiro Kitamura Masanori Iwanishi Akira Shimatsu Atsunori Kashiwagi |
| author_sort | Yukako Yamamoto |
| collection | DOAJ |
| description | To determine the normalization of postprandial blood glucose (PG) and triglyceride (TG) excursions in 30 morbidly obese patients with or without diabetes mellitus (DM) 1-year after they underwent a laparoscopic sleeve gastrectomy (LSG) vs. their pre-surgery data, we administered the 75-g oral glucose tolerance test (OGTT) and a meal tolerance test (MTT) using a 75-g glucose-equivalent carbohydrate- and fat-containing meal. The results were as follows; (i) Postoperative body-weight reduction was associated with DM remission and reduced multiple cardiometabolic risks. (ii) OGTT data showing postprandial hyper-insulinemic hypoglycemia in many post-surgery patients were associated with overdiagnosis of improved glucose tolerance. However, postoperative MTT data without hypoglycemia showed no improvement in the glucose tolerance vs. pre-surgery data. (iii) The disposition index (DI) i.e., [Matsuda index] × (Glucose-induced insulin secretion) was progressively worsened from normal glucose tolerance to DM patients after LSG. These post-surgery DI values measured by the MTT were correlated with 2h-plasma glucose levels and were not normalized in DM patients. (iv) The baseline, 2h-TG, and an increase in 2h-TG values above baseline were correlated with the insulin resistance index, DI, or HbA1c; These TG values were normalized post-LSG. In conclusion, the glucose tolerance curve measured by the MTT was not normalized in T2DM patients, which was associated with impaired normalization of the DI values in those patients 1-year after the LSG. However, the baseline TG and a fat-induced 2h-TG values were normalized postoperatively. The MTT can be used to assess normalization in postprandial glucose and TG excursions after LSG. |
| format | Article |
| id | doaj-art-4f01e7c907f94ea690a13c97ccf31a53 |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-4f01e7c907f94ea690a13c97ccf31a532025-01-22T06:25:09ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402023-12-0170121141115710.1507/endocrj.EJ23-0241endocrjThe oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomyYukako Yamamoto0Takeshi Togawa1Osamu Sekine2Yuki Ozamoto3Junko Fuse4Choka Azuma5Jun Ito-Kobayashi6Yasumitsu Oe7Akeo Hagiwara8Masaki Kobayashi9Tadahiro Kitamura10Masanori Iwanishi11Akira Shimatsu12Atsunori Kashiwagi13Department of Diabetes and Endocrinology, Omi Medical Center, Shiga 525-8585, JapanDepartment of Bariatric and Metabolic Surgery, Omi Medical Center, Shiga 525-8585, JapanDepartment of Diabetes and Endocrinology, Omi Medical Center, Shiga 525-8585, JapanDepartment of Bariatric and Metabolic Surgery, Omi Medical Center, Shiga 525-8585, JapanNutritional Department, Omi Medical Center, Shiga 525-8585, JapanDepartment of Diabetes and Endocrinology, Omi Medical Center, Shiga 525-8585, JapanDepartment of Diabetes and Endocrinology, Omi Medical Center, Shiga 525-8585, JapanDepartment of Bariatric and Metabolic Surgery, Omi Medical Center, Shiga 525-8585, JapanDepartment of Bariatric and Metabolic Surgery, Omi Medical Center, Shiga 525-8585, JapanMetabolic Signal Research Center, Institute for Molecular and Cellular Regulation, Gunma University, Gunma 371-8512, JapanMetabolic Signal Research Center, Institute for Molecular and Cellular Regulation, Gunma University, Gunma 371-8512, JapanDepartment of Diabetes and Endocrinology, Omi Medical Center, Shiga 525-8585, JapanDepartment of Diabetes and Endocrinology, Omi Medical Center, Shiga 525-8585, JapanDepartment of Diabetes and Endocrinology, Omi Medical Center, Shiga 525-8585, JapanTo determine the normalization of postprandial blood glucose (PG) and triglyceride (TG) excursions in 30 morbidly obese patients with or without diabetes mellitus (DM) 1-year after they underwent a laparoscopic sleeve gastrectomy (LSG) vs. their pre-surgery data, we administered the 75-g oral glucose tolerance test (OGTT) and a meal tolerance test (MTT) using a 75-g glucose-equivalent carbohydrate- and fat-containing meal. The results were as follows; (i) Postoperative body-weight reduction was associated with DM remission and reduced multiple cardiometabolic risks. (ii) OGTT data showing postprandial hyper-insulinemic hypoglycemia in many post-surgery patients were associated with overdiagnosis of improved glucose tolerance. However, postoperative MTT data without hypoglycemia showed no improvement in the glucose tolerance vs. pre-surgery data. (iii) The disposition index (DI) i.e., [Matsuda index] × (Glucose-induced insulin secretion) was progressively worsened from normal glucose tolerance to DM patients after LSG. These post-surgery DI values measured by the MTT were correlated with 2h-plasma glucose levels and were not normalized in DM patients. (iv) The baseline, 2h-TG, and an increase in 2h-TG values above baseline were correlated with the insulin resistance index, DI, or HbA1c; These TG values were normalized post-LSG. In conclusion, the glucose tolerance curve measured by the MTT was not normalized in T2DM patients, which was associated with impaired normalization of the DI values in those patients 1-year after the LSG. However, the baseline TG and a fat-induced 2h-TG values were normalized postoperatively. The MTT can be used to assess normalization in postprandial glucose and TG excursions after LSG.https://www.jstage.jst.go.jp/article/endocrj/70/12/70_EJ23-0241/_html/-char/enmorbid obesitymetabolic surgerymeal tolerance testoral disposition indexmetabolic remission |
| spellingShingle | Yukako Yamamoto Takeshi Togawa Osamu Sekine Yuki Ozamoto Junko Fuse Choka Azuma Jun Ito-Kobayashi Yasumitsu Oe Akeo Hagiwara Masaki Kobayashi Tadahiro Kitamura Masanori Iwanishi Akira Shimatsu Atsunori Kashiwagi The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy Endocrine Journal morbid obesity metabolic surgery meal tolerance test oral disposition index metabolic remission |
| title | The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy |
| title_full | The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy |
| title_fullStr | The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy |
| title_full_unstemmed | The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy |
| title_short | The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy |
| title_sort | oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy |
| topic | morbid obesity metabolic surgery meal tolerance test oral disposition index metabolic remission |
| url | https://www.jstage.jst.go.jp/article/endocrj/70/12/70_EJ23-0241/_html/-char/en |
| work_keys_str_mv | AT yukakoyamamoto theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT takeshitogawa theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT osamusekine theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT yukiozamoto theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT junkofuse theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT chokaazuma theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT junitokobayashi theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT yasumitsuoe theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT akeohagiwara theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT masakikobayashi theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT tadahirokitamura theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT masanoriiwanishi theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT akirashimatsu theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT atsunorikashiwagi theoraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT yukakoyamamoto oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT takeshitogawa oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT osamusekine oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT yukiozamoto oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT junkofuse oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT chokaazuma oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT junitokobayashi oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT yasumitsuoe oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT akeohagiwara oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT masakikobayashi oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT tadahirokitamura oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT masanoriiwanishi oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT akirashimatsu oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy AT atsunorikashiwagi oraldispositionindexcalculatedfromamealtolerancetestisacrucialindicatorforevaluatingdifferentialnormalizationofpostprandialglucoseandtriglycerideexcursionsinmorbidlyobesepatientsafterlaparoscopicsleevegastrectomy |