Gastrointestinal Hormones and Weight Loss Maintenance Following Roux-en-Y Gastric Bypass.

Abstract

CONTEXT:

Factors underlying variable weight loss (WL) after Roux-en-Y gastric bypass (RYGB) are poorly understood.

OBJECTIVE:

Our objective was to gain insight on the role of gastrointestinal hormones on poor WL maintenance (P-WLM) following RYGB.

DESIGN AND PATIENTS:

First, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and ghrelin responses to a standardized mixed liquid meal (SMLM) were compared between subjects with good WL (G-WL, n = 32) or P-WLM (n = 22). Second, we evaluated food intake (FI) following blockade of gut hormonal secretion in G-WL (n = 23) or P-WLM (n = 19) subjects. Finally, the impact of dietary-induced WL on the hormonal response in subjects with P-WLM (n = 14) was assessed.

SETTING:

This study was undertaken in a tertiary hospital.

MAIN OUTCOME MEASURES:

In studies 1 and 3, the outcomes measures were the areas under the curve of gut hormones following a SMLM; in study 2, FI following subcutaneous injection of saline or octreotide were evaluated.

RESULTS:

P-WLM associated a blunted GLP-1 (P = .044) and PYY (P = .001) responses and lesser suppression of ghrelin (P = .032) following the SMLM challenge. On saline day, FI in the G-WL (393 ± 143 kcal) group was less than in the P-WLM (519 ± 143 Kcal; P = .014) group. Octreotide injection resulted in enlarged FI in both groups (G-WL: 579 ± 248 kcal, P = .014; P-WLM: 798 ± 284 Kcal, P = .036), but the difference in FI between groups remained (P < .001). In subjects with P-WLM, dietary-induced WL resulted in larger ghrelin suppression (P = .046), but no change in the GLP-1 or PYY responses.

CONCLUSION:

Our data show gastrointestinal hormones play a role in the control of FI following RYGB, but do not support that changes in GLP-1, PYY, or ghrelin play a major role as determinants of P-WLM after this type of surgery.

• Authors: Ana de Hollanda, Gregori Casals, Salvadora Delgado, Amanda Jiménez, Judith Viaplana, Antonio M Lacy, Josep Vidal
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 100 Issue 12 Pg. 4677-84 (Dec 2015) ISSN: 1945-7197 [Electronic] United States
• PMID: 26505823 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Gastrointestinal Hormones
• Ghrelin
• Peptide YY
• Glucagon-Like Peptide 1
• Octreotide

Topics

• Adult
• Case-Control Studies
• Cohort Studies
• Diet
• Diet, Reducing
• Eating
• Female
• Gastric Bypass
• Gastrointestinal Hormones (blood)
• Ghrelin (blood)
• Glucagon-Like Peptide 1 (blood)
• Humans
• Male
• Middle Aged
• Obesity, Morbid (diet therapy, metabolism, surgery)
• Octreotide (pharmacology)
• Peptide YY (blood)
• Treatment Outcome
• Weight Loss