Lisosan G(发酵小麦)对减肥手术后反应性低血糖的疗效。

IF 2.5 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Obesity research & clinical practice Pub Date : 2024-11-16 DOI:10.1016/j.orcp.2024.11.004
Diego Moriconi, Laura Pucci, Vincenzo Longo, Luca Antonioli, Rosario Bellini, Domenico Tricò, Simona Baldi, Monica Nannipieri
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引用次数: 0

摘要

导言:减肥后低血糖症(PBH)被认为是胃旁路术(RYGB)后的一种慢性并发症,影响约 30% 的患者。目前的治疗方法通常侧重于营养干预,以减少发作频率。这项前瞻性研究评估了利索散 G(LG)(一种添加到饮食中的基于小麦的发酵补充剂)在减轻 PBH 发作方面的有效性,并阐明了其对肠道-胰腺轴的作用机制。方法:20 名患有 PBH 的受试者入组,他们在 2015 年至 2018 年期间接受了 RYGB。受试者接受了临床检查、血液检测和 3 小时口服葡萄糖负荷试验(OGTT)。然后,他们在连续葡萄糖监测(CGM)的自由饮食中接受了 2 周的监测,在同样的饮食中补充 LG(5 克,每天两次)后又延长了 2 周。最后,受试者重复进行 OGTT 和血液测试。结果:治疗后,观察到 PBH 时间明显减少(75[23-113] vs 16 [0-33],分钟,p 结论:LG 可有效减少 PBH 时间:LG 可有效降低 PBH 频率并缩短持续时间,这可能是通过降低 GLP-1 浓度并导致葡萄糖反应胰岛素分泌第二阶段的减少而实现的。这些发现强调了 LG 作为 PBH 新型辅助疗法的前景,尤其是在饮食中添加 LG 时,并强调了进一步探索其微生物群调节和抗炎作用的必要性。
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Efficacy of Lisosan G (fermented wheat) on reactive hypoglycemia after bariatric surgery.

Introduction: post-bariatric hypoglycemia (PBH) is considered a chronic complication after gastric bypass (RYGB) impacting roughly 30 % of patients. Current treatments often focus on nutritional interventions to reduce the frequency of episodes. This prospective study evaluated the effectiveness of Lisosan G (LG), a fermented wheat-based supplement added to the diet, in mitigating PBH episodes and elucidating its mechanism of action on the gut-pancreas axis.

Methods: twenty subjects with PBH, who had undergone RYGB between 2015 and 2018, were enrolled. Subjects underwent clinical examination, blood test, and a 3-hour oral glucose load test (OGTT). Then, they were monitored for 2-weeks on a free diet with continuous glucose monitoring (CGM), which was extended for another 2-weeks after introduction of LG supplementation (5 g, twice daily) on the same diet. Finally, subjects repeated OGTT and blood test. PBH was defined as interstitial glucose ≤ 54 mg/dl.

Results: after treatment, a marked reduction in PBH time was observed (75[23-113] vs 16 [0-33], minutes, p < 0.001). During OGTT, there was an increase in glucose nadir (44 ± 11 vs 56 ± 10, mg/dl, p = 0.038), and a significantly decrease in total GLP-1 AUC (7.6 ± 4.1 vs 6.5 ± 3.8, nmol/L*min, p = 0.043), in potentiation factor ratio (p = 0.037) and in total insulin AUC (57 ± 12 vs 49 ± 9, nmol/L*min, p = 0.043).

Conclusion: LG effectively reduces PBH frequency and duration, probably by attenuating GLP-1 concentrations and leading to a decrease in the second phase of insulin secretion in response to glucose. These findings underscore the promise of LG as a novel adjunct therapy for PBH, particularly when added to the diet, and emphasize the need for further exploration into its microbiota-modulating and anti-inflammatory effects.

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来源期刊
Obesity research & clinical practice
Obesity research & clinical practice 医学-内分泌学与代谢
CiteScore
7.10
自引率
0.00%
发文量
80
审稿时长
49 days
期刊介绍: The aim of Obesity Research & Clinical Practice (ORCP) is to publish high quality clinical and basic research relating to the epidemiology, mechanism, complications and treatment of obesity and the complication of obesity. Studies relating to the Asia Oceania region are particularly welcome, given the increasing burden of obesity in Asia Pacific, compounded by specific regional population-based and genetic issues, and the devastating personal and economic consequences. The journal aims to expose health care practitioners, clinical researchers, basic scientists, epidemiologists, and public health officials in the region to all areas of obesity research and practice. In addition to original research the ORCP publishes reviews, patient reports, short communications, and letters to the editor (including comments on published papers). The proceedings and abstracts of the Annual Meeting of the Asia Oceania Association for the Study of Obesity is published as a supplement each year.
期刊最新文献
Efficacy of Lisosan G (fermented wheat) on reactive hypoglycemia after bariatric surgery.
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