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Obesity Surgery

, Volume 19, Issue 5, pp 601–607 | Cite as

Alterations in Proinsulin and Insulin Dynamics, HDL Cholesterol and ALT After Gastric Bypass Surgery. A 42-Months Follow-up Study

  • Johansson Hans-Erik
  • Haenni Arvo
  • Öhrvall Margareta
  • Sundbom Magnus
  • Zethelius Björn
Research Article

Abstract

Background

Roux-en-Y gastric bypass (RYGBP) powerfully reduces type 2 diabetes (T2DM) incidence. Proinsulin predicts development of T2DM. Adjustable gastric banding is associated with lowered proinsulin but after RYGBP information is scant.

Methods

Twenty-one non-diabetic morbidly obese patients who underwent RYGBP surgery were evaluated before (baseline), at 12 months (first follow-up), and at 42 months, range 36–50 (second follow-up), after surgery and compared to a control group, matched at baseline regarding fasting glucose, insulin, proinsulin, alanine aminotransferase (ALT), high-density lipoprotein (HDL) cholesterol, and body mass index (BMI).

Results

In the RYGBP group, fasting serum proinsulin concentrations were markedly lowered from 13.5 to 3.5 pmol/l at first follow-up and to 4.9 pmol/l at second follow-up (p < 0.001, respectively). Fasting insulin concentrations were reduced from 83.4 to 24.6 pmol/l at first follow-up (p < 0.001) and to 36.4 pmol/l at second follow-up (p < 0.01). ALT was lowered from 0.62 to 0.34 μkatal/l at first follow-up and continued to lower to 0.24 μkatal/l at second follow-up (p < 0.001, respectively). The further decrease between first and second follow-up was also significant (p = 0.002). HDL cholesterol increased from 1.16 to 1.45 mmol/l at the first follow-up and continued to increase at second follow-up to 1.58 mmol/l (p < 0.001, respectively). The further increase between first and second follow-up was also significant (p = 0.006). The differences between groups at first follow-up were significant for BMI, proinsulin, insulin, ALT, and HDL cholesterol (p = 0.04–0.001).

Conclusion

RYGBP surgery in morbidly obese patients is not only characterized by markedly and sustained lowered BMI but also lowered concentrations of proinsulin, insulin, and ALT and increased HDL cholesterol.

Keywords

Morbid obesity Gastric bypass surgery Proinsulin ALT HDL cholesterol 

Notes

Acknowledgements

This study is funded by research grants from: The Family Ernfors Fund for Diabetes Research, the Swedish Diabetes Association, the Erik, Karin, and Gösta Selander fund, Uppsala University, the Thureus fund, the Thuring family foundation, Uppsala County Research Development, Capio Research Fund, and finally the Research and Development Department, Primary Care, Uppsala County.

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Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Johansson Hans-Erik
    • 1
  • Haenni Arvo
    • 1
  • Öhrvall Margareta
    • 1
  • Sundbom Magnus
    • 2
  • Zethelius Björn
    • 1
  1. 1.Department of Public Health and Caring Sciences/GeriatricsUppsala University HospitalUppsalaSweden
  2. 2.Department of Surgical SciencesUppsala University HospitalUppsalaSweden

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