(Wednesday, April 27, HealthDay News) - gastric bypass surgery has been known to improve glycemic control, often send people with diabetes type 2 in remission, but experts have long wondered exactly how this occurs.
Now, a new study provides some clues.
Movement of amino acids associated with insulin resistance significantly decrease of those who have the bypass, the researchers found. They compared the 10 obese diabetic who had surgery with 11 who lost weight through dieting.
"Something happens after gastric bypass happens not long after weight loss induced by the diet,", said Dr. Blandine Laferrere, Associate Professor of medicine at St. Luke-Roosevelt Hospital Center and Columbia University, New York.
The study is published in the issue April 27 translational Medical Science.
The surgery, which reduces the stomach of the size of a small pocket, also modifies the junction between the stomach and small intestine. It leads to a dramatic reduction in the level of amino acids that have been associated with diabetes in circulation.
"The fact that gastric bypass causes the remission of diabetes in the majority of the patients is not new," said Laferrere. According to information from bottom in the study, 50-80% of cases of diabetes pass in remission after surgery.
What doctors have tried to understand, she said, is why the bypass is so good to make diabetes to disappear. "Diabetes improves almost immediately, before that occurs a significant amount of weight loss," she said. "Which highlights that it is something other than weight loss."
In the new study, researchers assessed biochemical compounds involved in metabolic reactions among participants. Each group had lost about 20 pounds.
The researchers found that patients of bypass had much lower amino acid known as branched amino acid and acid amino phenylalanine and tyrosine.
"These changes in amino acids could be involved in the mechanism of diabetes after gastric bypass," said Laferrere.
Experts know that amino acids are related to resistance to insulin in part by studies on animals, she said. "If complete you the feeding of rats with amino acids branched, you can induce insulin resistance," she explained.
However, Laferrere said, the finding does not mean all obese diabetics should choose surgery on a diet. Surgery is very intrusive, she noted, and not everyone is a candidate.
The results are interesting, she says, but it is too early for applying in the treatment of diabetes. Finally, she added, when experts understand more about how the surgery affects the amino acids, it may be possible to apply the findings to develop better treatments for diabetes or less invasive surgery.
The new study adds weight to other research finding a link between the decline in the branched amino acids and the decline in the resistance, insulin, said Dr. Thomas j. Wang, Professor Associate Professor of medicine at Harvard Medical School and a co-author of the perspective that accompany the study.
"It is known that gastric bypass quickly reverses resistance to insulin, which is one of the main biochemical abnormalities that precedes diabetes," said Wang.
"This study really helps to confirm this hypothesis that branched amino acid down more in people who have Bariatric Surgery," he said. While he supports the idea that there is a link between the reduction in amino acids and decrease insulin resistance, it does not prove cause and effect, Wang added.
"It shows people who attain Bariatric Surgery have a greater fall in their branched chain amino acids." Which has not yet been proven is whether if this reduction in the branched amino acids is the reason for which their insulin resistance decreased, "he noted."
Wang and his co-author, Dr. Robert Gerszten, are co-inventors on patent applications related to predictors of metabolite of diabetes.
Wang and Gerszten also noted that the number of obese diabetic type 2 was $ 171 million in the world in 2000. By 2030, this number will double. Therefore, they have written, if a detailed understanding of the role of amino acids in diabetes it would be useful.
More information
For more information on the gastric bypass, visit the U.S. National Library of Medicine.
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