PMID- 27336358
OWN - NLM
STAT- MEDLINE
DCOM- 20170630
LR  - 20191210
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 101
IP  - 10
DP  - 2016 Oct
TI  - Risk Factors for Spontaneously Self-Reported Postprandial Hypoglycemia After 
      Bariatric Surgery.
PG  - 3600-3607
AB  - CONTEXT: Postprandial hypoglycemia (PPHG) is a recognized complication of 
      Roux-en-Y gastric bypass (RYGB) surgery. Data on PPHG after laparoscopic sleeve 
      gastrectomy (LSG) are scant. OBJECTIVE: The objective of the study was to 
      identify preoperative predictors of PPHG in subjects spontaneously self-reporting 
      PPHG after RYGB or LSG. Patients, Setting, and Intervention: Nondiabetic patients 
      spontaneously self-reporting symptoms/signs of PPHG (PPHG group, 21 RYGB and 11 
      LSG) were compared in a case-control design with subjects who never experienced 
      spontaneous or oral glucose tolerance test (OGTT)-induced hypoglycemia over 24 
      months after surgery (No-PPHG group, 13 RYGB and 40 LSG). Paired pre- and 
      postoperative 3-hour OGTTs were analyzed in all participants. MAIN OUTCOME 
      MEASURES: Insulin sensitivity was assessed by the oral glucose insulin 
      sensitivity index and beta-cell function by mathematical modeling of the C-peptide 
      response to glucose. RESULTS: Before surgery, the body mass index was lower in 
      PPHG than No-PPHG patients in the RYGB (P = .002) and trended similarly in the 
      LSG group (P = .08). Fasting glycemia and the glucose-OGTT nadir were lower in 
      the PPHG than the No-PPHG subjects in both surgery groups. Before surgery, 
      insulin sensitivity was higher in PPHG than No-PPHG in the RYGB (393 +/- 55 vs 325 
      +/- 44 mL/min(-1) . m(-2), P = .001) and LSG groups (380 +/- 48 vs 339 +/- 60 
      mL/min(-1) . m(-2), P = .05) and improved to a similar extent in all groups after 
      surgery. Before surgery, beta-cell glucose sensitivity was higher in PPHG than 
      No-PPHG in both RYGB (118 +/- 67 vs 65 +/- 24 pmol/min(-1) . m(2) . mM(-1)) and LSG 
      patients (114 +/- 32 vs 86 +/- 33) (both P = .02) and improved in all subjects after 
      surgery. CONCLUSIONS: In subjects self-reporting PPHG after surgery, lower 
      presurgery plasma glucose concentrations, higher insulin sensitivity, and better 
      beta-cell glucose sensitivity are significant predictors of PPHG after both RYGB and 
      LSG.
FAU - Nannipieri, Monica
AU  - Nannipieri M
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Belligoli, Anna
AU  - Belligoli A
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Guarino, Daniela
AU  - Guarino D
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Busetto, Luca
AU  - Busetto L
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Moriconi, Diego
AU  - Moriconi D
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Fabris, Roberto
AU  - Fabris R
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Mari, Andrea
AU  - Mari A
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Baldi, Simona
AU  - Baldi S
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Anselmino, Marco
AU  - Anselmino M
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Foletto, Mirto
AU  - Foletto M
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Vettor, Roberto
AU  - Vettor R
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
FAU - Ferrannini, Ele
AU  - Ferrannini E
AD  - Department of Clinical and Experimental Medicine (M.N., D.G., D.M., S.B.), 
      University of Pisa, 56126 Pisa, Italy; Departments of Medicine (A.B., L.B., R.F., 
      R.V.) and Oncology and Surgery Science (M.F.), University of Padua, 35122 Padua, 
      Italy; National Research Council Institute of Neurosciences (A.M.), Padua, Italy; 
      Bariatric Surgery Unit (M.A.), Santa Chiara Hospital, 56100 Pisa, Italy; National 
      Research Council Institute of Clinical Physiology (E.F.), 56124 Pisa, Italy.
LA  - eng
PT  - Journal Article
DEP - 20160623
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
SB  - IM
MH  - Adult
MH  - Bariatric Surgery/*adverse effects
MH  - Case-Control Studies
MH  - Female
MH  - Humans
MH  - Hypoglycemia/blood/*diagnosis/*etiology
MH  - Male
MH  - Middle Aged
MH  - Obesity/*surgery
MH  - *Outcome Assessment, Health Care
MH  - Prognosis
MH  - Risk Factors
MH  - Self Report
EDAT- 2016/06/24 06:00
MHDA- 2017/07/01 06:00
CRDT- 2016/06/24 06:00
PHST- 2016/06/24 06:00 [pubmed]
PHST- 2017/07/01 06:00 [medline]
PHST- 2016/06/24 06:00 [entrez]
AID - 10.1210/jc.2016-1143 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2016 Oct;101(10):3600-3607. doi: 10.1210/jc.2016-1143. 
      Epub 2016 Jun 23.