Insulin-like growth factor 1 predicts post-load hypoglycemia following bariatric surgery: a prospective cohort study

Postprandial hypoglycemia is a complication following gastric bypass surgery, which frequently remains undetected. Severe hypoglycemic episodes, however, put patients at risk, e.g., for syncope. A major cause of hypoglycemia following gastric bypass is hyperinsulinemic nesidioblastosis. Since pancre...

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Bibliographic Details
Published in:PloS one 2014-04, Vol.9 (4), p.e94613-e94613
Main Authors: Itariu, Bianca K, Zeyda, Maximilian, Prager, Gerhard, Stulnig, Thomas M
Format: Article
Language:English
Subjects:
Adult
Bariatric Surgery - adverse effects
Bioindicators
Biology and Life Sciences
Biomarkers
Biomarkers - blood
Body mass
Body measurements
Bypasses
Cohort analysis
Cohort Studies
Diabetes
Diabetes mellitus
Diagnosis
Diagnostic systems
Endocrinology
Female
Gastric bypass
Gastroenterology
Gastrointestinal surgery
Glucose
Glucose tolerance
Glucose Tolerance Test
Humans
Hypoglycemia
Hypoglycemia - blood
Hypoglycemia - etiology
Immunotherapy
Insulin
Insulin resistance
Insulin-like growth factor 1
Insulin-like growth factor I
Insulin-Like Growth Factor I - metabolism
Insulin-like growth factors
Laboratories
Liver
Longitudinal Studies
Male
Medicine
Medicine and Health Sciences
Metabolism
Metabolites
Mortality
Obesity
Pancreas
Patients
Physiological aspects
Prospective Studies
Risk
Risk factors
Surgery
Syncope
Weight control
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Summary:Postprandial hypoglycemia is a complication following gastric bypass surgery, which frequently remains undetected. Severe hypoglycemic episodes, however, put patients at risk, e.g., for syncope. A major cause of hypoglycemia following gastric bypass is hyperinsulinemic nesidioblastosis. Since pancreatic islets in nesidioblastosis overexpress insulin-like growth factor 1 (IGF-1) receptor α and administration of recombinant IGF-1 provokes hypoglycemia, our main objective was to investigate the occurrence of post-load hypoglycemia one year after bariatric surgery and its relation to pre- and post-operative IGF-1 serum concentrations. We evaluated metabolic parameters including 2 h 75 g oral glucose tolerance test (OGTT) and measured IGF-1 serum concentration in thirty-six non-diabetic patients (29 f/7 m), aged 41.3±2.0 y with a median (IQR) BMI of 30.9 kg/m2 (27.5-34.3 kg/m2), who underwent elective bariatric surgery (predominantly gastric bypass, 83%) at our hospital. Post-load hypoglycemia as defined by a 2 h glucose concentration
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0094613