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Diabetologia. 2015 Oct;58(10):2254-8. doi: 10.1007/s00125-015-3696-3. Epub 2015 Jul 18.

Effect of Roux-en-Y gastric bypass on the distribution and hormone expression of small-intestinal enteroendocrine cells in obese patients with type 2 diabetes.

Author information

1
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, DK-2900, Hellerup, Denmark.
2
NNF Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
3
Novo Nordisk Scandinavia AB, Copenhagen, Denmark.
4
Unit of Enteroscopy, Department of Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
5
Gastro Unit D, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
6
Gubra Aps, Hørsholm, Denmark.
7
Gastro Unit, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
8
Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, DK-2900, Hellerup, Denmark. filipknop@dadlnet.dk.
9
NNF Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark. filipknop@dadlnet.dk.

Abstract

AIMS/HYPOTHESIS:

We studied the impact of Roux-en-Y gastric bypass (RYGB) on the density and hormonal gene expression of small-intestinal enteroendocrine cells in obese patients with type 2 diabetes.

METHODS:

Twelve patients with diabetes and 11 age- and BMI-matched controls underwent RYGB followed by enteroscopy ~10 months later. Mucosal biopsies taken during surgery and enteroscopy were immunohistochemically stained for glucagon-like peptide-1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), glucose-dependent insulinotropic polypeptide (GIP) and prohormone convertase 2 (PC2) and the expression of GCG (encoding preproglucagon), PYY, CCK, GIP, GHRL (encoding ghrelin), SCT (encoding secretin), NTS (encoding neurotensin) and NR1H4 (encoding farnesoid X receptor) was evaluated.

RESULTS:

The density of cells immunoreactive for GLP-1, CCK and GIP increased in patients after RYGB and the density of those immunoreactive for GLP-1, PYY, CCK and PC2 increased in controls. In both groups, GHRL, SCT and GIP mRNA was reduced after RYGB while PYY, CCK, NTS and NR1H4 gene expression was unaltered. GCG mRNA was upregulated in both groups.

CONCLUSIONS/INTERPRETATION:

Numerous alterations in the distribution of enteroendocrine cells and their expression of hormonal genes are seen after RYGB and include increased density of GLP-1-, PYY-, CCK-, GIP- and PC2-positive cells, reduced gene expression of GHRL, SCT and GIP and increased expression of GCG.

KEYWORDS:

Cholecystokinin; Enteroendocrine cells; Ghrelin; Glucagon-like peptide-1; Glucose-dependent insulinotropic polypeptide; Immunohistochemistry; Obesity; Peptide YY; Quantitative polymerase chain reaction; Roux-en-Y gastric bypass; Type 2 diabetes

PMID:
26186884
DOI:
10.1007/s00125-015-3696-3
[Indexed for MEDLINE]

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