Glucose Metabolism Parameters and Post-Prandial GLP-1 and GLP-2 Release Largely Vary in Several Distinct Situations: a Controlled Comparison Among Individuals with Crohn's Disease and Individuals with Obesity Before and After Bariatric Surgery

Author(s)

Magro, Daniela Oliveira ^[1] ; Cazzo, Everton ^[1] ; Kotze, Paulo Gustavo ^[2] ; Junqueira Vasques, Ana Carolina ^[3] ; Real Martinez, Carlos Augusto ^[1] ; Chaim, Elinton Adami ^[1] ; Geloneze, Bruno ^[3] ; Pareja, Jose Carlos ^[1] ; Rodrigues Coy, Claudio Saddy ^[1]

Affiliation

^[1] State Univ Campinas UNICAMP, Fac Med Sci, Dept Surg, R Alexander Fleming S-N, BR-13083887 Campinas, SP - Brazil

^[2] Catholic Univ Parana, Cajuru Univ Hosp, Colorectal Surg Unit, Curitiba, Parana - Brazil

^[3] State Univ Campinas UNICAMP, Gastroctr, Res Lab Metab & Diabet LIMED, Campinas, SP - Brazil

• Document type: Journal article
• Source: OBESITY SURGERY; v. 28, n. 2, p. 378-388, FEB 2018.
• Web of Science Citations: 1

Abstract

Background This study aims to compare the post-prandial curves of glucose, insulin, GLP-1, and GLP-2 among individuals with Crohn's disease (CD), obese individuals before and after bariatric surgery, and healthy controls. Methods This an exploratory cross-sectional study that involved five groups of patients (two groups of individuals with CD-active and inactive), bariatric patients (pre- and post-surgery, who were their own controls), and a distinct separated control group of healthy volunteers. C-reactive protein (CRP) levels and the post-prandial curves of glucose, insulin, GLP-1, and GLP-2 curves were assessed and compared. Results The pre-RYGB group presented significantly higher levels of CRP than the post-RYGB (p = 0.001) and the control group (p = 0.001). The inactive CD group presented a higher post-prandial GLP-1 area under the curve (AUC) than the pre-RYGB group (p = 0.009). The post-RYGB group presented significantly higher AUCs of GLP-2 than the pre-RYGB group (p < 0.0001), both inactive and active CD groups (p < 0.0001 in both situations), and the control group (p = 0.002). The pre-RYGB group presented a significantly higher AUC of glucose than the post-RYGB (p = 0.02) and both active and inactive CD groups (p = 0.019 and p = 0.046, respectively). The pre-RYGB group presented a significantly higher AUC of insulin than the control (p = 0.005) and both CD groups (p < 0.0001). Conclusions Obesity is associated with an inflammatory state comparable to the one observed in CD; inflammation may also be enrolled in the blockade of GLP-2. CD individuals present a more incretin-driven pattern of glucose metabolism, as a way to prevent hypoglycemia and compensate the carbohydrate malabsorption and GLP-2 blockade. (AU)

• FAPESP's process: 14/06164-8 - Evaluation of circulating levels of Glucagon-like-peptide 1 and 2 in human subjects with Crohns Disease
• Grantee: Claudio Saddy Rodrigues Coy
• Support Opportunities: Regular Research Grants