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Entero-endocrine changes after gastric bypass in diabetic and nondiabetic patients: a preliminary study.
J Surg Res. 2007 Jul; 141(1):31-9.JS

Abstract

INTRODUCTION

Alterations in entero-endocrine signaling may play a role in improvements in satiety and glucose tolerance after Roux-en-Y gastric bypass (RYGB). We report our findings of gut hormone secretion in a cohort of diabetic and nondiabetic morbidly obese patients.

MATERIALS AND METHODS

Ten morbidly obese subjects who underwent uncomplicated RYGB were studied: 5 were diabetic and 9 were female. Nonfasting plasma levels of glucagon-like peptide-1 (GLP-1), insulin, desacyl ghrelin, active ghrelin, neuropeptide Y (NPY), and gastric inhibitory polypeptide (GIP) were determined preoperatively and 6 months postoperatively.

RESULTS

Mean patient age was 42 +/- 11 years, and the mean preoperative body mass index was 50 +/- 6 kg/m(2). At 6 months mean BMI fell to 33 +/- 5 kg/m(2) (P < 0.0001), and there were no differences between diabetics and nondiabetics with respect to amount of weight loss. In non-diabetics, compared to preoperative levels, there were significant increases in GLP-1 and desacyl-ghrelin in the nondiabetic patients (P = 0.046 and P = 0.016, respectively); no change in plasma insulin, active ghrelin, NPY, or GIP was demonstrated. In contrast, when compared to preoperative levels, there were no significant changes in entero-endocrine hormone levels in the diabetic cohort postoperatively.

CONCLUSIONS

At 6 months postoperation, RYGB significantly alters the hormone levels for GLP-1 and desacyl-ghrelin in morbidly obese nondiabetic patients. No significant change was noted in a matched cohort of diabetic patients. Weight loss was similar in diabetics and nondiabetics, suggesting that GLP-1 and ghrelin are not the only mechanisms producing weight loss after RYGB.

Authors+Show Affiliations

Department of Surgery, Division of Gastrointestinal Surgery, University of Minnesota, Minneapolis, Minnesota, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

17574036

Citation

Whitson, Bryan A., et al. "Entero-endocrine Changes After Gastric Bypass in Diabetic and Nondiabetic Patients: a Preliminary Study." The Journal of Surgical Research, vol. 141, no. 1, 2007, pp. 31-9.
Whitson BA, Leslie DB, Kellogg TA, et al. Entero-endocrine changes after gastric bypass in diabetic and nondiabetic patients: a preliminary study. J Surg Res. 2007;141(1):31-9.
Whitson, B. A., Leslie, D. B., Kellogg, T. A., Maddaus, M. A., Buchwald, H., Billington, C. J., & Ikramuddin, S. (2007). Entero-endocrine changes after gastric bypass in diabetic and nondiabetic patients: a preliminary study. The Journal of Surgical Research, 141(1), 31-9.
Whitson BA, et al. Entero-endocrine Changes After Gastric Bypass in Diabetic and Nondiabetic Patients: a Preliminary Study. J Surg Res. 2007;141(1):31-9. PubMed PMID: 17574036.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Entero-endocrine changes after gastric bypass in diabetic and nondiabetic patients: a preliminary study. AU - Whitson,Bryan A, AU - Leslie,Daniel B, AU - Kellogg,Todd A, AU - Maddaus,Michael A, AU - Buchwald,Henry, AU - Billington,Charles J, AU - Ikramuddin,Sayeed, PY - 2007/01/08/received PY - 2007/02/08/revised PY - 2007/02/11/accepted PY - 2007/6/19/pubmed PY - 2007/8/10/medline PY - 2007/6/19/entrez SP - 31 EP - 9 JF - The Journal of surgical research JO - J Surg Res VL - 141 IS - 1 N2 - INTRODUCTION: Alterations in entero-endocrine signaling may play a role in improvements in satiety and glucose tolerance after Roux-en-Y gastric bypass (RYGB). We report our findings of gut hormone secretion in a cohort of diabetic and nondiabetic morbidly obese patients. MATERIALS AND METHODS: Ten morbidly obese subjects who underwent uncomplicated RYGB were studied: 5 were diabetic and 9 were female. Nonfasting plasma levels of glucagon-like peptide-1 (GLP-1), insulin, desacyl ghrelin, active ghrelin, neuropeptide Y (NPY), and gastric inhibitory polypeptide (GIP) were determined preoperatively and 6 months postoperatively. RESULTS: Mean patient age was 42 +/- 11 years, and the mean preoperative body mass index was 50 +/- 6 kg/m(2). At 6 months mean BMI fell to 33 +/- 5 kg/m(2) (P < 0.0001), and there were no differences between diabetics and nondiabetics with respect to amount of weight loss. In non-diabetics, compared to preoperative levels, there were significant increases in GLP-1 and desacyl-ghrelin in the nondiabetic patients (P = 0.046 and P = 0.016, respectively); no change in plasma insulin, active ghrelin, NPY, or GIP was demonstrated. In contrast, when compared to preoperative levels, there were no significant changes in entero-endocrine hormone levels in the diabetic cohort postoperatively. CONCLUSIONS: At 6 months postoperation, RYGB significantly alters the hormone levels for GLP-1 and desacyl-ghrelin in morbidly obese nondiabetic patients. No significant change was noted in a matched cohort of diabetic patients. Weight loss was similar in diabetics and nondiabetics, suggesting that GLP-1 and ghrelin are not the only mechanisms producing weight loss after RYGB. SN - 0022-4804 UR - https://www.unboundmedicine.com/medline/citation/17574036/Entero_endocrine_changes_after_gastric_bypass_in_diabetic_and_nondiabetic_patients:_a_preliminary_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(07)00090-X DB - PRIME DP - Unbound Medicine ER -