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    Obes Surg. 2008 Mar;18(3):300-5. Epub 2008 Jan 16.

    Short-term overfeeding induces insulin resistance in weight-stable patients after bariatric surgery.

    Source

    Nutrition and Toxicology Research Institute Maastricht, Department of General Surgery, Maastricht University/University Hospital Maastricht, PO Box 616, 6200 MD, Maastricht, The Netherlands.

    Abstract

    BACKGROUND:

    Short time overfeeding of rats rapidly leads to insulin resistance (IR). A study with healthy human volunteers, which we suggest are less susceptible for developing IR after short time overfeeding, did not show these effects on IR. Therefore a study population of weight-stable, former morbidly obese subjects (BMI 31.3 kg/m2), which were treated with bariatric surgery approximately 3 years ago was selected.

    METHODS:

    Eleven subjects were submitted to a 7-day overfeeding study, resulting in a 53% increase in caloric intake (1,227 +/- 394.4 to 1,879.2 +/- 298.4 kcal/day). During normal diet and after overfeeding, insulin sensitivity was measured using steady state plasma glucose (SSPG) levels. At these time points, BMI and waist/hip ratio together with plasma levels of inflammatory markers (CRP, AGP, LBP, and TNF-alpha receptors) and plasma leptin values were also measured.

    RESULTS:

    SSPG levels after overfeeding increased from 8.2 +/- 3.2 to 10.6 +/- 2.6 mmol/l (P < 0.05), indicating decreased insulin sensitivity after overfeeding. Fasting plasma insulin, glucose, circulating levels of inflammatory markers, BMI, and waist/hip ratio remained unchanged.

    CONCLUSIONS:

    This study shows that overfeeding in a group of weight-stable, former morbidly obese subjects 3 years after bariatric surgery results in decreased insulin sensitivity. The mechanisms behind decreased insulin sensitivity induced by overfeeding are poorly understood, but the present results reveal that a unique human model is available to study these mechanisms, leading to a better understanding of the pathophysiology of IR.

    PMID:
    18197457
    [PubMed - indexed for MEDLINE]

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