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Accelerated Gastric Emptying but No Carbohydrate Malabsorption 1 Year After Gastric Bypass Surgery (GBP)

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An Erratum to this article was published on 08 May 2013

Abstract

Background

Following gastric bypass surgery (GBP), there is a post-prandial rise of incretin and satiety gut peptides. The mechanisms of enhanced incretin release in response to nutrients after GBP is not elucidated and may be in relation to altered nutrient transit time and/or malabsorption.

Methods

Seven morbidly obese subjects (BMI = 44.5 ± 2.8 kg/m2) were studied before and 1 year after GBP with a d-xylose test. After ingestion of 25 g of d-xylose in 200 mL of non-carbonated water, blood samples were collected at frequent time intervals to determine gastric emptying (time to appearance of d-xylose) and carbohydrate absorption using standard criteria.

Results

One year after GBP, subjects lost 45.0 ± 9.7 kg and had a BMI of 27.1 ± 4.7 kg/m2. Gastric emptying was more rapid after GBP. The mean time to appearance of d-xylose in serum decreased from 18.6 ± 6.9 min prior to GBP to 7.9 ± 2.7 min after GBP (p = 0.006). There was no significant difference in absorption before (serum d-xylose concentrations = 35.6 ± 12.6 mg/dL at 60 min and 33.9 ± 9.1 mg/dL at 180 min) or 1 year after GBP (serum d-xylose = 31.5 ± 18.1 mg/dL at 60 min and 27.2 ± 11.9 mg/dL at 180 min).

Conclusions

These data confirm the acceleration of gastric emptying for liquid and the absence of carbohydrate malabsorption 1 year after GBP. Rapid gastric emptying may play a role in incretin response after GBP and the resulting improved glucose homeostasis.

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Acknowledgments

We thank our participants, the technicians from the NYONRC Hormonal Core Laboratory, Yim Dam and Ping Zhou, the GCRC-CTSA staff, Toni Colarusso for recruiting participants, and Dr. Julio Teixeira, Dr. James McGinty, and Dr. Ninan Koshy—bariatric surgeons—for allowing access to their patients for research studies. Part of the data were presented at the 71st Scientific Sessions of the American Diabetes Association (Diabetes 2011; 60 (Suppl. 1):A48, 174-OR), San Diego, CA, USA, 24–28 June 2011. This study was funded by grants from the American Diabetes Association—CR-7-05 CR-18 and from the NIH—R01-DK67561, PO1-DK58398, 1 UL1 RR024156-02, DK-26687, and DK-63068-05.

Disclosures

The authors have no competing interests.

Author information

Authors and Affiliations

  1. New York Obesity Nutrition Research Center, New York, NY, USA

    Gary Wang, Keesandra Agenor, Justine Pizot, Yaniv Harel, Bart J. Van Der Schueren, Iliana Quercia & Blandine Laferrère

  2. Division of Endocrinology and Diabetes, Department of Medicine, St. Luke’s Roosevelt Hospital Center, New York, NY, USA

    Blandine Laferrère

  3. Division of Gastroenterology, Department of Medicine, St. Luke’s Roosevelt Hospital Center, New York, NY, USA

    Donald P. Kotler

  4. Division of Minimally Invasive Surgery, Department of Surgery, St. Luke’s Roosevelt Hospital Center, New York, NY, USA

    James McGinty

  5. St. Luke’s Roosevelt Hospital Center, New York, NY, USA

    Gary Wang, Keesandra Agenor, Donald P. Kotler, James McGinty & Blandine Laferrère

  6. Columbia University College of Physicians and Surgeons, 1111 Amsterdam Avenue, R-1034, New York, NY, 10025, USA

    Donald P. Kotler, James McGinty & Blandine Laferrère

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  1. Gary Wang
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Correspondence to Blandine Laferrère.

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Wang, G., Agenor, K., Pizot, J. et al. Accelerated Gastric Emptying but No Carbohydrate Malabsorption 1 Year After Gastric Bypass Surgery (GBP). OBES SURG 22, 1263–1267 (2012). https://doi.org/10.1007/s11695-012-0656-6

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