In vivo mapping of postprandial hepatic glucose metabolism using dynamic magnetic resonance spectroscopy combined with stable isotope flux analysis in Roux‐en‐Y gastric bypass adults and non‐operated controls: A case–control study
Authors' conclusion
Exploiting DMI with stable isotope flux analysis, we observed distinct postprandial hepatic glucose trajectories and parameters of glucose-insulin homeostasis in RYGB patients with PBH versus HCs. Despite altered postprandial glucose kinetics and higher insulin exposure, there was no evidence of impaired hepatic glucose uptake or output predisposing to PBH in RYGB patients.
Study context
- Population
- RYGB-operated adults with post-bariatric hypoglycaemia (PBH) and non-operated healthy controls (HC)
- Participants
- 10 vs 10
- Comparison
- RYGB-operated adults with PBH vs non-operated HC
- RYGBn = 10
- HCn = 10reference
- Outcome
- Postprandial hepatic glucose metabolism (deuterium metabolic imaging (DMI) with stable isotope flux analysis)
- Follow-up
- Until 150 min (DMI); 180 min (blood)
Methodological detailsGlucose fluxes assessed by mathematical modelling; trajectories described with generalized additive models
- Glucose fluxes assessed by mathematical modelling; trajectories described with generalized additive models
Main finding
As reported in the abstract
- Hepatic d-glucose signal increased early then decreased in RYGB; gradual increase and stabilisation in HC
- Postprandial hepatic glycogen accumulation and suppression of endogenous glucose production lower in RYGB vs HC despite higher insulin exposure, indicating lower hepatic insulin sensitivity
- Faster systemic rate of ingested d-glucose in RYGB, with higher, earlier plasma glucose peak and increased insulin secretion
- Postprandial glucose disposal increased in RYGB; no between-group difference in peripheral insulin sensitivity
Original publication
In vivo mapping of postprandial hepatic glucose metabolism using dynamic magnetic resonance spectroscopy combined with stable isotope flux analysis in Roux‐en‐Y gastric bypass adults and non‐operated controls: A case–control study. Diabetes Obes Metab. Published 14 October 2024. doi:10.
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