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GLP-1

GLP-1 test could predict efficacy of bypass on T2DM remission

Test could lead to a novel predictive biomarker for personalised treatment of T2DM and obesity

A hormone test may be able to predict the extent of metabolic improvement caused by the gastric bypass, according to the results of a rodent study by researchers from the Institute of Diabetes and Obesity (IDO), Helmholtz Zentrum München, Germany, and the University of Cincinnati, Ohio.

They report that the sensitivity of the glucagon-like peptide 1(GLP-1 hormone), can predict the metabolic efficacy of a gastric bypass, and therefore could be used as a novel predictive biomarker for personalised treatment of type 2 diabetes and obesity. The results were published in the journal Diabetes,

Professor Matthias Tschöp

“If our results are confirmed in clinical trials with patients, the hormone response could be tested before the planned surgery and surgeons would be able to predict how much an individual patient’s glucose metabolism would benefit,” said Professor Matthias Tschöp, Helmholtz Zentrum München. “This will contribute to the development of personalized therapies for type 2 diabetes and obesity. For surgical procedures such as gastric bypass this is particularly compelling because such operations are complex and cannot be easily reversed.”

One hundred ninety-seven high-fat-diet-induced obese male Long-Evans rats were monitored for body weight loss loss during Exendin-4 (Ex4) administration. Stable populations of responders and non-responders were identified based on Ex4-induced BW loss and GLP-1-induced improvements in glucose tolerance.

Sub-populations of Ex4 extreme responders and non-responders received RYGB. Following RYGB, responders and non-responders showed similar BW loss compared to sham, but non-responders retained impaired glucose tolerance.

“These findings present an opportunity to optimize the use of bariatric surgery based on an improved understanding of GLP-1 biology and suggest an opportunity for a more personalised therapeutic approach to the metabolic syndrome,” they conclude. “This latest study showed that GLP-1 responsiveness varied considerably with regard to glucose metabolism, and the more responsive the animals were to GLP-1, the greater the efficacy of the gastric bypass turned out to be regarding glucose metabolism improvements. Thus, the responsiveness to GLP-1 could be a key indicator for the success of the gastric bypass.”

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