Changes in gut hormone profile and glucose homeostasis after laparoscopic sleeve gastrectomy.

Abstract

BACKGROUND:

Changes in glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) levels after bariatric surgery have been proposed as a mechanism for long-term maintenance of weight loss and improvement in glucose homeostasis postoperatively. The objective of the present study was to assess the changes in GLP-1, PYY, insulin, and glucose levels after laparoscopic sleeve gastrectomy (SG).

METHODS:

Ten morbidly obese patients without type 2 diabetes (3 male, 7 female; body mass index [BMI] 47.92±2.06 kg/m(2)) were evaluated preoperatively and at 6 weeks, 6 months, and 12 months after SG. Total GLP-1, total PYY, insulin, and glucose were measured in fasting state and every 30 minutes after ingestion of 75 g glucose for a total time of 120 minutes.

RESULTS:

BMI decreased markedly postoperatively (P<.001). Postprandial total GLP-1 and total PYY responses, measured by the area under the curve (AUC), were significantly increased by the sixth postoperative week compared with preoperative period (P<.001). Fasting insulin levels were markedly decreased postoperatively at all time points (all P<.01). Insulin AUC decreased progressively throughout the first postoperative year (P = .04), whereas glucose AUC decreased significantly at 6 and 12 months postoperatively (both P<.01). Insulin sensitivity measured by the Matsuda index increased progressively postoperatively. First phase insulin secretion remained unchanged.

CONCLUSION:

Postprandial total GLP-1 and total PYY levels increased significantly at 6 weeks post-SG and remained elevated for at least 1 year. These findings may indicate their involvement in better glucose homeostasis and weight loss maintenance after SG.

• Authors: Dimitris Papamargaritis, Carel W le Roux, Eleni Sioka, George Koukoulis, George Tzovaras, Dimitris Zacharoulis
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) 2013 Mar-Apr Vol. 9 Issue 2 Pg. 192-201 ISSN: 1878-7533 [Electronic] United States
• PMID: 23183113 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Chemical References

• Blood Glucose
• Gastrointestinal Hormones
• Insulin
• Peptide YY
• Glucagon-Like Peptide 1

Topics

• Adult
• Area Under Curve
• Bariatric Surgery (methods)
• Blood Glucose (metabolism)
• Body Mass Index
• Diabetes Mellitus, Type 2 (complications, metabolism)
• Female
• Gastrectomy (methods)
• Gastrointestinal Hormones (metabolism)
• Glucagon-Like Peptide 1 (metabolism)
• Homeostasis (physiology)
• Humans
• Insulin (metabolism)
• Laparoscopy (methods)
• Male
• Obesity, Morbid (complications, metabolism, surgery)
• Peptide YY (metabolism)
• Postoperative Care (methods)
• Prospective Studies