A1 Journal article – refereed
Liver blood dynamics after bariatric surgery: the effects of mixed-meal test and incretin infusions




List of Authors: Honka H, Koffert J, Kauhanen S, Kudomi N, Hurmes S, Mari A, Lindqvise A, Wierup N, Parkkole R, Groop L, Nuutila P
Publisher: BIOSCIENTIFICA LTD
Publication year: 2018
Journal: Endocrine Connections
Journal name in source: ENDOCRINE CONNECTIONS
Journal acronym: ENDOCR CONNECT
Volume number: 7
Issue number: 7
Number of pages: 9
ISSN: 2049-3614
eISSN: 2049-3614

Abstract
Aims/hypothesis: The mechanisms for improved glycemic control after bariatric surgery in subjects with type 2 diabetes (T2D) are not fully known. We hypothesized that dynamic hepatic blood responses to a mixed-meal are changed after bariatric surgery in parallel with an improvement in glucose tolerance.Methods: A total of ten morbidly obese subjects with T2D were recruited to receive a mixed-meal and a glucose-dependent insulinotropic polypeptide (GIP) infusion before and early after (within a median of less than three months) bariatric surgery, and hepatic blood flow and volume (HBV) were measured repeatedly with combined positron emission tomography/MRI. Ten lean non-diabetic individuals served as controls.Results: Bariatric surgery leads to a significant decrease in weight, accompanied with an improved 13-cell function and glucagon-like peptide 1 (GLP-1) secretion, and a reduction in liver volume. Blood flow in portal vein (PV) was increased by 1.65-fold (P=0.026) in response to a mixed-meal in subjects after surgery, while HBV decreased in all groups (P< 0.001). When the effect of GIP infusion was tested separately, no change in hepatic arterial and PV flow was observed, but HBV decreased as seen during the mixed-meal test.Conclusions/interpretation: Early after bariatric surgery, PV flow response to a mixedmeal is augmented, improving digestion and nutrient absorption. GIP influences the post-prandial reduction in HBV thereby diverting blood to the extrahepatic sites.

Last updated on 2019-20-07 at 13:25