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Investigating Intestinal Glucagon after Roux-en-Y Gastric Bypass Surgery

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Jorsal, Tina ; Wewer Albrechtsen, Nicolai J ; Christensen, Marie M ; Mortensen, Brynjulf ; Wandall, Erik ; Langholz, Ebbe ; Friis, Steffen ; Worm, Dorte ; Ørskov, Cathrine ; Støving, René K ; Andries, Alin ; Juhl, Claus B ; Sørensen, Frederik ; Forman, Julie L ; Falkenhahn, Mechthilde ; Musholt, Petra B ; Theis, Stefan ; Larsen, Philip J ; Holst, Jens J ; Vrang, Niels ; Jelsing, Jacob ; Vilsbøll, Tina ; Knop, Filip K. / Investigating Intestinal Glucagon after Roux-en-Y Gastric Bypass Surgery. In: The Journal of clinical endocrinology and metabolism. 2019.

Bibtex

@article{97d8ce60a11142ee8aebbec655f073ac,
title = "Investigating Intestinal Glucagon after Roux-en-Y Gastric Bypass Surgery",
abstract = "CONTEXT: After Roux-en-Y gastric bypass (RYGB) surgery, postprandial plasma glucagon concentrations have been reported to increase. This occurs despite concomitant improved glucose tolerance and increases in circulating plasma concentrations of insulin and the glucagon-inhibiting hormone glucagon-like peptide 1 (GLP-1).OBJECTIVE: Investigate whether RYGB-induced hyperglucagonemia may be derived from the gut.DESIGN AND SETTING: Sub-study of a prospective cross-sectional study at a university hospital in Copenhagen, Denmark.PARTICIPANTS: Morbidly obese individuals undergoing RYGB [n=8] with or without type 2 diabetes.INTERVENTIONS: Three months before and after RYGB, participants underwent upper enteroscopy with gastrointestinal mucosal biopsy retrieval. Mixed meal tests were performed 1 week and 3 months before and after RYGB.MAIN OUTCOME MEASURES: 29-amino acid glucagon concentrations in plasma and in mucosal gastrointestinal biopsies were assessed using mass spectrometry-validated immunoassays, and a new monoclonal antibody reacting with immunoreactive glucagon was used for immunohistochemistry.RESULTS: We observed increased postprandial plasma concentrations of glucagon after RYGB. Small intestinal expression of the glucagon gene increased after surgery. Glucagon was identified in the small intestinal biopsies obtained after, but not before RYGB. Immunohistochemically, mucosal biopsies from the small intestine harbored cells co-staining for GLP-1 and immuno-reactive glucagon.CONCLUSIONS: Increased concentrations of glucagon, estimated by two glucagon specific assays, were observed in small intestinal biopsies and postprandially in plasma after RYGB. The small intestine harbored cells immunohistochemically co-staining for GLP-1 and glucagon-like immunoreactivity after RYGB. These findings suggest that glucagon derived from small intestinal enteroendocrine L-cells may contribute to postprandial plasma concentrations of glucagon after RYGB.",
author = "Tina Jorsal and {Wewer Albrechtsen}, {Nicolai J} and Christensen, {Marie M} and Brynjulf Mortensen and Erik Wandall and Ebbe Langholz and Steffen Friis and Dorte Worm and Cathrine {\O}rskov and St{\o}ving, {Ren{\'e} K} and Alin Andries and Juhl, {Claus B} and Frederik S{\o}rensen and Forman, {Julie L} and Mechthilde Falkenhahn and Musholt, {Petra B} and Stefan Theis and Larsen, {Philip J} and Holst, {Jens J} and Niels Vrang and Jacob Jelsing and Tina Vilsb{\o}ll and Knop, {Filip K}",
note = "Copyright {\circledC} 2019 Endocrine Society.",
year = "2019",
month = "7",
day = "5",
doi = "10.1210/jc.2019-00062",
language = "English",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The/Endocrine Society",

}

RIS

TY - JOUR

T1 - Investigating Intestinal Glucagon after Roux-en-Y Gastric Bypass Surgery

AU - Jorsal, Tina

AU - Wewer Albrechtsen, Nicolai J

AU - Christensen, Marie M

AU - Mortensen, Brynjulf

AU - Wandall, Erik

AU - Langholz, Ebbe

AU - Friis, Steffen

AU - Worm, Dorte

AU - Ørskov, Cathrine

AU - Støving, René K

AU - Andries, Alin

AU - Juhl, Claus B

AU - Sørensen, Frederik

AU - Forman, Julie L

AU - Falkenhahn, Mechthilde

AU - Musholt, Petra B

AU - Theis, Stefan

AU - Larsen, Philip J

AU - Holst, Jens J

AU - Vrang, Niels

AU - Jelsing, Jacob

AU - Vilsbøll, Tina

AU - Knop, Filip K

N1 - Copyright © 2019 Endocrine Society.

PY - 2019/7/5

Y1 - 2019/7/5

N2 - CONTEXT: After Roux-en-Y gastric bypass (RYGB) surgery, postprandial plasma glucagon concentrations have been reported to increase. This occurs despite concomitant improved glucose tolerance and increases in circulating plasma concentrations of insulin and the glucagon-inhibiting hormone glucagon-like peptide 1 (GLP-1).OBJECTIVE: Investigate whether RYGB-induced hyperglucagonemia may be derived from the gut.DESIGN AND SETTING: Sub-study of a prospective cross-sectional study at a university hospital in Copenhagen, Denmark.PARTICIPANTS: Morbidly obese individuals undergoing RYGB [n=8] with or without type 2 diabetes.INTERVENTIONS: Three months before and after RYGB, participants underwent upper enteroscopy with gastrointestinal mucosal biopsy retrieval. Mixed meal tests were performed 1 week and 3 months before and after RYGB.MAIN OUTCOME MEASURES: 29-amino acid glucagon concentrations in plasma and in mucosal gastrointestinal biopsies were assessed using mass spectrometry-validated immunoassays, and a new monoclonal antibody reacting with immunoreactive glucagon was used for immunohistochemistry.RESULTS: We observed increased postprandial plasma concentrations of glucagon after RYGB. Small intestinal expression of the glucagon gene increased after surgery. Glucagon was identified in the small intestinal biopsies obtained after, but not before RYGB. Immunohistochemically, mucosal biopsies from the small intestine harbored cells co-staining for GLP-1 and immuno-reactive glucagon.CONCLUSIONS: Increased concentrations of glucagon, estimated by two glucagon specific assays, were observed in small intestinal biopsies and postprandially in plasma after RYGB. The small intestine harbored cells immunohistochemically co-staining for GLP-1 and glucagon-like immunoreactivity after RYGB. These findings suggest that glucagon derived from small intestinal enteroendocrine L-cells may contribute to postprandial plasma concentrations of glucagon after RYGB.

AB - CONTEXT: After Roux-en-Y gastric bypass (RYGB) surgery, postprandial plasma glucagon concentrations have been reported to increase. This occurs despite concomitant improved glucose tolerance and increases in circulating plasma concentrations of insulin and the glucagon-inhibiting hormone glucagon-like peptide 1 (GLP-1).OBJECTIVE: Investigate whether RYGB-induced hyperglucagonemia may be derived from the gut.DESIGN AND SETTING: Sub-study of a prospective cross-sectional study at a university hospital in Copenhagen, Denmark.PARTICIPANTS: Morbidly obese individuals undergoing RYGB [n=8] with or without type 2 diabetes.INTERVENTIONS: Three months before and after RYGB, participants underwent upper enteroscopy with gastrointestinal mucosal biopsy retrieval. Mixed meal tests were performed 1 week and 3 months before and after RYGB.MAIN OUTCOME MEASURES: 29-amino acid glucagon concentrations in plasma and in mucosal gastrointestinal biopsies were assessed using mass spectrometry-validated immunoassays, and a new monoclonal antibody reacting with immunoreactive glucagon was used for immunohistochemistry.RESULTS: We observed increased postprandial plasma concentrations of glucagon after RYGB. Small intestinal expression of the glucagon gene increased after surgery. Glucagon was identified in the small intestinal biopsies obtained after, but not before RYGB. Immunohistochemically, mucosal biopsies from the small intestine harbored cells co-staining for GLP-1 and immuno-reactive glucagon.CONCLUSIONS: Increased concentrations of glucagon, estimated by two glucagon specific assays, were observed in small intestinal biopsies and postprandially in plasma after RYGB. The small intestine harbored cells immunohistochemically co-staining for GLP-1 and glucagon-like immunoreactivity after RYGB. These findings suggest that glucagon derived from small intestinal enteroendocrine L-cells may contribute to postprandial plasma concentrations of glucagon after RYGB.

U2 - 10.1210/jc.2019-00062

DO - 10.1210/jc.2019-00062

M3 - Journal article

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

ER -

ID: 57540366