Evidence mapPaperPMID 39153140Full record

ArticleObesity surgery2024

Post-Bariatric Hypoglycemia: an Impaired Metabolic Response to a Meal.

Ömrüm Aydin, Abraham S Meijnikman, Patrick A de Jonge, Karlijn van Stralen, Hanneke Börger, Kadriye Okur, Zainab Iqbal, Moritz V Warmbrunn, Yair I Z Acherman, Sjoerd Bruin and 8 more

Abstract read
In one paragraph

Article in Obesity surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Ömrüm AydinDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Abraham S MeijnikmanDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Patrick A de JongeDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Karlijn van StralenDepartment of Scientific Research, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Hanneke BörgerDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Kadriye OkurDepartment of Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Zainab IqbalCardiometabolic Research, Vrije Universiteit, Amsterdam, the Netherlands.
Moritz V WarmbrunnDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Yair I Z AchermanDepartment of Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Sjoerd BruinDepartment of Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Maaike WinkelmeijerDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Alinda W M SchimmelDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Jens J HolstNovo Nordisk Foundation Center for Basic Metabolic Research, Copenhagen, Denmark.
Steen S PoulsenDepartment of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
Fredrik BäckhedDepartment of Cardiovascular and Metabolic Research, Wallenberg Laboratory, Institute of Medicine, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
Max NieuwdorpDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Albert K GroenDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands.
Victor E A GerdesDepartment of Vascular Medicine, Amsterdam UMC - AMC, Amsterdam, the Netherlands. v.e.gerdes@amsterdamumc.nl.ORCID 0000-0003-0493-4399

Funding

Fondation Leducq 17CVD01Novo Nordisk Foundation Center for Basic Metabolic Research GUTMMMNovo Nordisk Foundation Center for Basic Metabolic Research GUTMMM grant 2016ZonMw 09150182010020
6 · The paper itself

Abstract

aims/hypothesisPost-bariatric hypoglycemia (PBH) is caused by postprandial hyperinsulinemia, due to anatomical alterations and changes in post-prandial metabolism after bariatric surgery. The mechanisms underlying the failing regulatory and compensatory systems are unclear. In this study, we investigated the differences in post-prandial hormones and metabolic profiles between patients with and without PBH.

methodsWe performed a mixed meal test (MMT) in 63 subjects before and 1 year after Roux-en-Y gastric bypass (RYGB) surgery. Blood was withdrawn at 0, 10, 20, 30, 60, and 120 min after ingestion of a standardized meal. Glucose, insulin, GLP-1, FGF-19, and FGF-21 were measured and untargeted metabolomics analysis was performed on blood plasma to analyze which hormonal and metabolic systems were altered between patients with and without PBH.

resultsOut of 63, a total of 21 subjects (33%) subjects developed PBH (glucose < 3.1 mmol/L) after surgery. Decreased glucose and increased insulin excursions during MMT were seen in PBH (p < 0.05). GLP-1, FGF-19, and FGF-21 were elevated after surgery (p < 0.001), but did not differ between PBH and non-PBH groups. We identified 20 metabolites possibly involved in carbohydrate metabolism which differed between the two groups, including increased carnitine and acylcholines in PBH.

conclusionOverall, 33% of the subjects developed PBH 1 year after RYGB surgery. While GLP-1, FGF-19, and FGF-21 were similar in PBH and non-PBH patients, metabolomics analysis revealed changes in carnitine and acyclcholines that are possibly involved in energy metabolism, which may play a role in the occurrence of PBH.

Indexed as

Blood GlucoseFibroblast Growth FactorsGastric BypassHypoglycemiaInsulinObesity, MorbidPostprandial PeriodAdultFemaleGlucagon-Like Peptide 1HumansHyperinsulinismMaleMealsMiddle AgedPostoperative ComplicationsBlood GlucoseFGF19 protein, humanfibroblast growth factor 21Fibroblast Growth FactorsGlucagon-Like Peptide 1InsulinBariatric surgeryFGF-19FGF-21GLP-1GluconeogenesisHypoglycemia

Identifiers

PMID39153140
PMCPMC11481667

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.