Fasting levels of glicentin are higher in Roux-en-Y gastric bypass patients exhibiting postprandial hypoglycemia during a meal test

Abstract Background Post-bypass postprandial hypoglycemia (PPH) is a frequent complication of Roux-en-Y Gastric Bypass (RYGB) but predictors remain poorly identified and are needed to assess individual risk. After RYGB, exaggerated secretion of glucagon-like peptide-1 (GLP-1) and insulin could lead to PPH, but other proglucagon-derived peptides, including glicentin and glucagon, could also contribute to this phenomenon. Objectives To identify biological hypoglycemia in relation to the secretion of proglucagon-derived peptides during a mixed-meal test (MMT) in RYGB patients. Setting University hospital. Methods Twenty RYGB patients reporting symptoms consistent with PPH were examined 36.9 ± 5.1 months after surgery. Plasma levels of glucose, c-peptide, glucagon, GLP-1 and glicentin were assessed before and during MMT. Patients with postprandial hypoglycemia ≤3 mM (54 mg/dL) during MMT were assigned to HYPO group and compared with patients not exhibiting hypoglycemia (NONHYPO group). Results Seven patients displayed hypoglycemia ≤3 mM (HYPO) during the MMT. Lower fasting glycemia (4.5 mM versus 5.3 mM, P P Conclusions These results suggest that fasting glicentin is a potential biomarker to examine in operated-obese patients at risk of developing PPH. Further studies are needed before proposing fasting glicentin as a predictive factor of PPH.