PMID- 27474690 OWN - NLM STAT- MEDLINE DCOM- 20170605 LR - 20191210 IS - 1479-6805 (Electronic) IS - 0022-0795 (Linking) VI - 231 IP - 1 DP - 2016 Oct TI - Endocrine effects of duodenal-jejunal exclusion in obese patients with type 2 diabetes mellitus. PG - 11-22 LID - 10.1530/JOE-16-0206 [doi] AB - Duodenal-jejunal bypass liner (DJBL) is an endoscopically implantable device designed to noninvasively mimic the effects of gastrointestinal bypass operations by excluding the duodenum and proximal jejunum from the contact with ingested food. The aim of our study was to assess the influence of DJBL on anthropometric parameters, glucose regulation, metabolic and hormonal profile in obese patients with type 2 diabetes mellitus (T2DM) and to characterize both the magnitude and the possible mechanisms of its effect. Thirty obese patients with poorly controlled T2DM underwent the implantation of DJBL and were assessed before and 1, 6 and 10months after the implantation, and 3months after the removal of DJBL. The implantation decreased body weight, and improved lipid levels and glucose regulation along with reduced glycemic variability. Serum concentrations of fibroblast growth factor 19 (FGF19) and bile acids markedly increased together with a tendency to restoration of postprandial peak of GLP1. White blood cell count slightly increased and red blood cell count decreased throughout the DJBL implantation period along with decreased ferritin, iron and vitamin B12 concentrations. Blood count returned to baseline values 3months after DJBL removal. Decreased body weight and improved glucose control persisted with only slight deterioration 3months after DJBL removal while the effect on lipids was lost. We conclude that the implantation of DJBL induced a sustained reduction in body weight and improvement in regulation of lipid and glucose. The increase in FGF19 and bile acids levels could be at least partially responsible for these effects. CI - (c) 2016 Society for Endocrinology. FAU - Kavalkova, Petra AU - Kavalkova P AD - Institute of Medical Biochemistry and Laboratory DiagnosticsFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Mraz, Milos AU - Mraz M AD - Third Department of Medicine - Department of Endocrinology and MetabolismFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Trachta, Pavel AU - Trachta P AD - Third Department of Medicine - Department of Endocrinology and MetabolismFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Klouckova, Jana AU - Klouckova J AD - Institute of Medical Biochemistry and Laboratory DiagnosticsFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Cinkajzlova, Anna AU - Cinkajzlova A AD - Institute of Medical Biochemistry and Laboratory DiagnosticsFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Lacinova, Zdenka AU - Lacinova Z AD - Institute of Medical Biochemistry and Laboratory DiagnosticsFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic Third Department of Medicine - Department of Endocrinology and MetabolismFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Haluzikova, Denisa AU - Haluzikova D AD - Department of Sports MedicineFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Benes, Marek AU - Benes M AD - Department of Gastroenterology and HepatologyInstitute for Clinical and Experimental Medicine, Prague, Czech Republic. FAU - Vlasakova, Zuzana AU - Vlasakova Z AD - Department of DiabetesInstitute for Clinical and Experimental Medicine, Prague, Czech Republic. FAU - Burda, Vaclav AU - Burda V AD - Department of CyberneticsFaculty of Electrical Engineering, Czech Technical University, Prague, Czech Republic. FAU - Novak, Daniel AU - Novak D AD - Department of CyberneticsFaculty of Electrical Engineering, Czech Technical University, Prague, Czech Republic. FAU - Petr, Tomas AU - Petr T AD - Institute of Medical Biochemistry and Laboratory DiagnosticsFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Vitek, Libor AU - Vitek L AD - Institute of Medical Biochemistry and Laboratory DiagnosticsFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic Fourth Department of Internal MedicineFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic. FAU - Pelikanova, Terezie AU - Pelikanova T AD - Department of DiabetesInstitute for Clinical and Experimental Medicine, Prague, Czech Republic. FAU - Haluzik, Martin AU - Haluzik M AD - Institute of Medical Biochemistry and Laboratory DiagnosticsFirst Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic Department of ObesitologyInstitute of Endocrinology, Prague, Czech Republic mhalu@lf1.cuni.cz. LA - eng PT - Evaluation Study PT - Journal Article DEP - 20160729 PL - England TA - J Endocrinol JT - The Journal of endocrinology JID - 0375363 RN - 0 (Bile Acids and Salts) RN - 0 (Blood Glucose) RN - 0 (FGF19 protein, human) RN - 0 (Lipids) RN - 62031-54-3 (Fibroblast Growth Factors) RN - 89750-14-1 (Glucagon-Like Peptide 1) SB - IM MH - Adult MH - Aged MH - Bariatric Surgery/*methods MH - Bile Acids and Salts/blood MH - Blood Glucose/metabolism MH - Diabetes Mellitus, Type 2/etiology/*metabolism/surgery MH - Duodenum/*surgery MH - Female MH - Fibroblast Growth Factors/blood MH - Glucagon-Like Peptide 1/blood MH - Humans MH - Jejunum/*surgery MH - Lipids/blood MH - Male MH - Middle Aged MH - Obesity/complications/*metabolism/surgery MH - Postoperative Period MH - Postprandial Period MH - Time Factors MH - Treatment Outcome MH - Weight Loss OTO - NOTNLM OT - bile acids OT - duodenal-jejunal bypass liner OT - fibroblast growth factor 19 OT - obesity OT - type 2 diabetes mellitus EDAT- 2016/07/31 06:00 MHDA- 2017/06/06 06:00 CRDT- 2016/07/31 06:00 PHST- 2016/07/21 00:00 [received] PHST- 2016/07/29 00:00 [accepted] PHST- 2016/07/31 06:00 [entrez] PHST- 2016/07/31 06:00 [pubmed] PHST- 2017/06/06 06:00 [medline] AID - JOE-16-0206 [pii] AID - 10.1530/JOE-16-0206 [doi] PST - ppublish SO - J Endocrinol. 2016 Oct;231(1):11-22. doi: 10.1530/JOE-16-0206. Epub 2016 Jul 29.