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ROUX-EN-Y GASTRIC BYPASS IS ASSOCIATED WITH INCREASED INTESTINAL GLUCOSE UPTAKE IN HUMANS
Florina Corpodean
*, Maryam Naseri, Michael Kachmar, Julia St Amant, Owen T., Vance L. Albaugh
Louisiana State University Pennington Biomedical Research Center, Baton Rouge, LA
Introduction:
Preclinical studies demonstrate that Roux-en-Y gastric bypass (RYGB) markedly increases Roux limb intestinal glucose uptake in mice, making the small intestine a ‘glucose consumer’ which may contribute to long-term weight loss and weight maintenance. While retrospective studies suggest this may occur in humans, prospective clinical studies are lacking. Thus, our current aim was to conduct a pilot study to (1) demonstrate feasibility of serial intestinal imaging using positron emission tomography with glucose tracer (18F-PET/CT), and (2) measure serial changes in glucose uptake along the intestinal tract at 3 and 6 months compared to preoperative values.
Materials and Methods:
Preoperative RYGB patients were recruited (n=8) and intestinal glucose uptake was measured serially in pre-defined regions of interest (ROI) with standard PET/CT imaging at baseline and then 3- and 6-months postoperatively. Maximum standardized uptake values (SUVmax) were measured from regions of interest (ROIs), including the cecum, hepatic flexure, splenic flexure, sigmoid colon, duodenal bulb, Roux limb, and common channel based on anatomic imaging landmarks. SUVmax ratios were normalized relative to the spleen for reference. Anthropomorphic data and serial weight measurements and glucose uptake data were analyzed using time series regression methods.
Results:
While no significant change in tracer uptake was observed in the Roux limb, there were significant increases in tracer uptake in the cecum, hepatic flexure, and sigmoid colon, particularly between baseline and 3 months (p<0.05). Similarly, the common channel also showed a significant increase in SUVmax (p=0.03), but due to the small sample size serial pair-wise comparisons were underpowered.
Conclusion:
Unlike the marked Roux limb glucose increases observed in rodents, subtle but significant increases in intestinal glucose uptake appear to occur in humans post-RYGB. Further study in humans is warranted to determine the clinical significance of these changes and their mechanisms.
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