Upregulation of intestinal glucose transporters after Roux-en-Y gastric bypass to prevent carbohydrate malabsorption

Obesity (Silver Spring). 2014 Oct;22(10):2164-71. doi: 10.1002/oby.20829. Epub 2014 Jul 2.

Abstract

Objective: To determine the effect of Roux-en-Y gastric bypass (RYGB) on the expression of intestinal sweet taste receptors (STRs), glucose transporters (GTs), glucose absorption, and glycemia.

Methods: Intestinal biopsies were collected for mRNA expression of STR (T1R2) and GTs (SGLT-1 and GLUT2) from 11 non-diabetic RYGB, 13 non-diabetic obese, and 11 healthy subjects, at baseline and following a 30 min small intestinal (SI) glucose infusion (30 g/150 ml water with 3 g 3-O-methyl-d-glucopyranose (3-OMG)). Blood glucose, plasma 3-OMG, and insulin were measured for 270 min.

Results: In RYGB patients, expression of both GTs was ∼2-fold higher at baseline and after glucose infusion than those of morbidly obese or healthy subjects (P < 0.001). STR expressions were comparable amongst the groups. Peak plasma 3-OMG in both RYGB (r = 0.69, P = 0.01) and obese (r = 0.72, P = 0.005) correlated with baseline expression of SGLT-1, as was the case with peak blood glucose in RYGB subjects (r = 0.69, P = 0.02).

Conclusions: The upregulated intestinal GTs in RYGB patients are associated with increased glucose absorption when glucose is delivered at a physiological rate, suggesting a molecular adaptation to prevent carbohydrate malabsorption from rapid intestinal transit after RYGB.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Carbohydrate Metabolism
  • Case-Control Studies
  • Female
  • Gastric Bypass* / adverse effects
  • Glucose / pharmacokinetics
  • Glucose Transport Proteins, Facilitative / genetics*
  • Glucose Transport Proteins, Facilitative / metabolism
  • Humans
  • Insulin / blood
  • Intestinal Absorption*
  • Intestinal Mucosa / metabolism*
  • Malabsorption Syndromes / genetics
  • Malabsorption Syndromes / metabolism
  • Malabsorption Syndromes / prevention & control*
  • Male
  • Middle Aged
  • Obesity, Morbid / genetics
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / surgery*
  • Up-Regulation / genetics

Substances

  • Blood Glucose
  • Glucose Transport Proteins, Facilitative
  • Insulin
  • Glucose