Obesity (Silver Spring, Md.) · 2026
Impact of Vertical Sleeve Gastrectomy in Youth-Onset Type 2 Diabetes: Changes in Glycemia, Insulin Sensitivity, and Secretion.
Клиническое исследование I фазыКлиническое исследование II фазыСтатьяНазвание и аннотация: Перевод в очереди
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Dobbs Tyler J, Pyle Laura, Moore Jaime M, Garrish Justin, Behn Cecilia Diniz, Weissenkampen Dylan, Baumgartner Amy D, Gross Susan, Schutte Grant, Birznieks Carissa, Melena Isabella, Remmers Lauryn, Driscoll Lynette, Cree Melanie G, Kelsey Megan M, Shah Amy S, Inge Thomas H, Bjornstad Petter, Nadeau Kristen J
Аннотация
OBJECTIVE: This study evaluated impacts of vertical sleeve gastrectomy (VSG) on glycemic and cardiometabolic outcomes in youth-onset type 2 diabetes (YO-T2D).
METHODS: Pre- and postoperative (3 and 12 months) anthropometrics, mixed-meal tolerance test (MMTT) and body composition assessments, and hyperglycemic clamps (preoperative and 12 months postoperatively) were performed.
RESULTS: Weight (-24.6 ± 5.2 kg at 3 months; -31.0 ± 5.2 kg at 12 months) and BMI (-8.5 ± 2.0 kg/m2; -10.8 kg/m2) fell by 18% and 23%, respectively (all p < 0.01). Body fat decreased 6.4% (p = 0.01) at 12 months, and fat mass by 16.8 ± 4.7 kg (p = 0.01). MMTT-stimulated GLP-1, PYY, insulin, and C-peptide secretion increased and insulin clearance, glucose, HbA1c (6.6% ± 0.2% to 5.7% ± 0.2%, p = 0.003), free fatty acids (FFA), LDL, triglycerides, adipose-focused Adipo-IR, liver transaminases and hepatic-predominant insulin sensitivity (Si) (HOMA-IR) decreased at 3 months post VSG. With maximal 12-month weight loss, MMTT-stimulated insulin, C-peptide, and GLP-1 responses attenuated, insulin clearance increased, muscle-predominant Si (hyperglycemic clamp M/I, Matsuda index, static/dynamic oral minimal modeling), β-cell function, resting heart rate, systolic blood pressure, and HDL improved, and all 3-month improvements persisted, with 86% of participants off diabetes medications.
CONCLUSIONS: VSG in YO-T2D produces rapid and sustained improvements in weight, body composition, cardiometabolic health, Si, FFA, β-cell function, and glycemia, with most no longer needing diabetes medications.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03620773.
METHODS: Pre- and postoperative (3 and 12 months) anthropometrics, mixed-meal tolerance test (MMTT) and body composition assessments, and hyperglycemic clamps (preoperative and 12 months postoperatively) were performed.
RESULTS: Weight (-24.6 ± 5.2 kg at 3 months; -31.0 ± 5.2 kg at 12 months) and BMI (-8.5 ± 2.0 kg/m2; -10.8 kg/m2) fell by 18% and 23%, respectively (all p < 0.01). Body fat decreased 6.4% (p = 0.01) at 12 months, and fat mass by 16.8 ± 4.7 kg (p = 0.01). MMTT-stimulated GLP-1, PYY, insulin, and C-peptide secretion increased and insulin clearance, glucose, HbA1c (6.6% ± 0.2% to 5.7% ± 0.2%, p = 0.003), free fatty acids (FFA), LDL, triglycerides, adipose-focused Adipo-IR, liver transaminases and hepatic-predominant insulin sensitivity (Si) (HOMA-IR) decreased at 3 months post VSG. With maximal 12-month weight loss, MMTT-stimulated insulin, C-peptide, and GLP-1 responses attenuated, insulin clearance increased, muscle-predominant Si (hyperglycemic clamp M/I, Matsuda index, static/dynamic oral minimal modeling), β-cell function, resting heart rate, systolic blood pressure, and HDL improved, and all 3-month improvements persisted, with 86% of participants off diabetes medications.
CONCLUSIONS: VSG in YO-T2D produces rapid and sustained improvements in weight, body composition, cardiometabolic health, Si, FFA, β-cell function, and glycemia, with most no longer needing diabetes medications.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03620773.