Short-term overfeeding induces insulin resistance in weight-stable patients after bariatric surgery

Obes Surg. 2008 Mar;18(3):300-5. doi: 10.1007/s11695-007-9306-9. Epub 2008 Jan 16.

Abstract

Background: Short time overfeeding of rats rapidly leads to insulin resistance (IR). A study with healthy human volunteers, which we suggest are less susceptible for developing IR after short time overfeeding, did not show these effects on IR. Therefore a study population of weight-stable, former morbidly obese subjects (BMI 31.3 kg/m2), which were treated with bariatric surgery approximately 3 years ago was selected.

Methods: Eleven subjects were submitted to a 7-day overfeeding study, resulting in a 53% increase in caloric intake (1,227 +/- 394.4 to 1,879.2 +/- 298.4 kcal/day). During normal diet and after overfeeding, insulin sensitivity was measured using steady state plasma glucose (SSPG) levels. At these time points, BMI and waist/hip ratio together with plasma levels of inflammatory markers (CRP, AGP, LBP, and TNF-alpha receptors) and plasma leptin values were also measured.

Results: SSPG levels after overfeeding increased from 8.2 +/- 3.2 to 10.6 +/- 2.6 mmol/l (P < 0.05), indicating decreased insulin sensitivity after overfeeding. Fasting plasma insulin, glucose, circulating levels of inflammatory markers, BMI, and waist/hip ratio remained unchanged.

Conclusions: This study shows that overfeeding in a group of weight-stable, former morbidly obese subjects 3 years after bariatric surgery results in decreased insulin sensitivity. The mechanisms behind decreased insulin sensitivity induced by overfeeding are poorly understood, but the present results reveal that a unique human model is available to study these mechanisms, leading to a better understanding of the pathophysiology of IR.

MeSH terms

  • Adult
  • Bariatric Surgery*
  • Blood Glucose / analysis
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Eating*
  • Energy Intake
  • Female
  • Humans
  • Inflammation Mediators / blood
  • Insulin Resistance*
  • Leptin / blood
  • Male
  • Obesity, Morbid / blood*
  • Obesity, Morbid / surgery

Substances

  • Blood Glucose
  • Inflammation Mediators
  • Leptin
  • C-Reactive Protein