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Changes in GIP gene expression following bariatric surgery

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Abstract

Background

After bariatric surgery, there is a significant improvement in type 2 diabetes (T2D). T2D has been linked to incretins, including glucose-dependent insulinotropic polypeptide (GIP). Analysis of bariatric surgery patients may help to understand the link between GIP and T2D.

Methods

Twenty-three morbidly obese patients underwent Roux-en-Y gastric bypass (RYGB) or gastric banding. Overall, there were 12 RYGB (5 T2D; 7 nondiabetic) patients and 11 gastric band (7 T2D; 4 nondiabetic) patients. Preoperative and postoperative blood samples were collected. Total RNA was extracted, cDNA synthesized, and real-time quantitative PCR were used to quantify gene expression. Student’s t test was used for statistical analysis.

Results

Postoperatively, T2D resolved or improved in 83.3 % (10/12) of the diabetic patients. Six (4 RYGB, 2 bands) patients discontinued hypoglycemic medications and four (3 RYGB, 1 band) patients discontinued the majority of their hypoglycemic agents. The remaining two diabetic patients (bands) showed no improvement. Postoperative GIP gene expression increased 4.36-fold (p = 0.02) in diabetic RYGB patients, whereas diabetic band patients increased 1.4-fold (p = 0.25). All diabetic patients with either resolution or improvement of T2D, had a 3.4-fold increase (p = 0.01) but nonresponders decreased 0.69-fold (p = 0.41). Nondiabetic RYGB patients increased 2.21-fold (p = 0.07) versus a 0.81-fold (p = 0.37) decrease of nondiabetic band patients.

Conclusions

This is one of the initial studies that show a significant increase in GIP gene expression following a RYGB. This increase correlates with the clinical resolution of T2D. The anatomical changes after RYGB may account for these changes. Based on this data, GIP may be a key peptide in the “foregut hypothesis” for resolution of T2D.

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Acknowledgments

The authors sadly report that Dr. Marcos Rojkind passed away during the final editing of this manuscript. We have been honored to work with him and are thankful for his invaluable contribution to this and other research projects. This work was partially supported by the National Institute of Health grant RO1AA 10541 (M. R.).

Disclosures

Erin Moran-Atkin, Fred Brody, Sidney Fu, and Marcos Rojkind have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, The George Washington University Medical Center, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA

    Erin Moran-Atkin & Fred Brody

  2. Department of Medicine, Microbiology, Immunology, and Tropical Medicine, The George Washington University, Washington, DC, USA

    Sidney W. Fu

  3. Department of Biochemistry and Molecular Biology, The George Washington University, Washington, DC, USA

    Marcos Rojkind

Authors
  1. Erin Moran-Atkin
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  2. Fred Brody
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  3. Sidney W. Fu
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  4. Marcos Rojkind
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Corresponding author

Correspondence to Erin Moran-Atkin.

Additional information

M. Rojkind: Deceased

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Moran-Atkin, E., Brody, F., Fu, S.W. et al. Changes in GIP gene expression following bariatric surgery. Surg Endosc 27, 2492–2497 (2013). https://doi.org/10.1007/s00464-012-2764-8

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