Abstract
ABSTRACTBackground: The role of gut hormones in glucose homeostasis and weight loss achievement and maintenance after bariatric surgery appears to be a key point in the understanding of the beneficial effects observed following these procedures. Aim: To determine whether there is a correlation between the pre and postoperative levels of both GLP-1 and GLP-2 and the excess weight loss after Roux-en-Y gastric bypass (RYGB). Methods: An exploratory prospective study which enrolled 11 individuals who underwent RYGB and were followed-up for 12 months. GLP-1 and GLP-2 after standard meal tolerance test (MTT) were determined before and after surgery and then correlated with the percentage of excess loss (%EWL). Results: GLP-2 AUC presented a significant postoperative increase (945.3±449.1 vs.1787.9±602.7; p=0.0037); GLP-1 AUC presented a non-significant trend towards increase after RYGB (709.6±320.4 vs. 1026.5±714.3; p=0.3808). Mean %EWL was 66.7±12.2%. There was not any significant correlation between both the pre and postoperative GLP-1 AUCs and GLP-2 AUCs and the %EWL achieved after one year. Conclusion: There was no significant correlation between the pre and postoperative levels of the areas under the GLP-1 and GLP-2 curves with the percentage of weight loss reached after one year.
Highlights
The role of gut hormones in glucose homeostasis and weight loss achievement and maintenance after bariatric surgery appears to be a key point in the understanding of the beneficial effects observed following these procedures
Surgery led to significant decreases in weight (123.5±13.1 vs. 85.3±16.1 kg; p
Significant correlations between the glucagon-like peptide 1 (GLP-1) and glucagonlike peptide 2 (GLP-2) levels and the weight loss achieved after Roux-en-Y gastric bypass (RYGB) were not found, signaling that it is possible that other factors should play a more relevant role in regards of weight loss and maintenance
Summary
The role of gut hormones in glucose homeostasis and weight loss achievement and maintenance after bariatric surgery appears to be a key point in the understanding of the beneficial effects observed following these procedures. The significant weight loss following Roux-en-Y gastric bypass (RYGB) has been extensively reported[2]. At first, it has been regarded as an effect of the diminishment in the volumetric capacity of the stomach, caused by the creation of a 20-40 ml pouch, along with the malabsorption caused by the exclusion of about 250 cm of the small bowel from the food transit[9,7,18]. The production and release of both glucagon-like peptide 1 (GLP-1) and glucagonlike peptide 2 (GLP-2) dramatically alter after surgery, especially when the procedures include duodenal exclusion or passage of more nutrients by the distal small bowel[13,20,21]. This study aimed to determine whether there is a significant correlation between
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