- •Among 9 hormones, postprandial Oxm and Glicentin increase most after bariatric surgery.
- •Early postoperative increase in Oxm and Glicentin predicts future weight loss.
- •Postoperative increase of satiety feeling is associated with plasma Oxm and Glicentin.
Bariatric surgery leads to profound and sustainable weight loss. Gastrointestinal hormones are involved in energy and glucose homeostasis, thus postoperative changes of their circulating levels may be mediating future weight loss. To investigate how the circulating concentrations of gastrointestinal hormones change in response to the most common types of bariatric operation and whether these changes can predict future weight loss.
Materials and Methods
We measured circulating GLP-1, GLP-2, oxyntomodulin, glicentin, glucagon, major proglucagon fragment (MPGF), ghrelin, GIP, PYY after overnight fasting and/or after a mixed meal test (MMT) in: a) 14 subjects that have undergone either an adjustable gastric banding [AGB] (n = 9) or a Roux-en-Y bypass (RYGB) (n = 5) (Pilot study 1), b) 28 subjects that have undergone either a vertical sleeve gastrectomy (n = 17) or a RYGB (n = 11) before and three, six and twelve months after surgery.
In addition to the expected associations with GLP-1, the most robust increases were observed in postprandial levels of oxyntomodulin and glicentin three months after VSG or RYGB (but not after AGB) and are associated with degree of weight loss. Oxyntomodulin and glicentin levels at the third and sixth month postoperative visit are positively associated with feeling of satiety which may be underlying the observed associations with future weight loss.
Beyond GLP-1, early postprandial changes in circulating oxyntomodulin and glicentin are predictors of weight loss after bariatric surgery, possibly through regulation of satiety. Further studies should focus on underlying mechanisms, and their potential as attractive therapeutic tools against obesity and related comorbidities.
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- Mechanisms of surgical control of type 2 diabetes: GLP-1 is key factor.Surg Obes Relat Dis. 2016; 12: 1236-1242
- The history of metabolic and bariatric surgery: development of standards for patient safety and efficacy.Metabolism. 2018; 79: 97-107
- Altered glucose metabolism after bariatric surgery: what's GLP-1 got to do with it?.Metabolism. 2018; 83: 159-166
- Pharmacotherapy of type 2 diabetes: an update.Metabolism. 2018; 78: 13-42
- The sustained effects of a dual GIP/GLP-1 receptor agonist, NNC0090-2746, in patients with type 2 diabetes.Cell Metab. 2017; 26 (343-52 e2)
- Future pharmacotherapy for obesity: new anti-obesity drugs on the horizon.Curr Obes Rep. 2018; 7: 147-161
- Discovery, characterization, and clinical development of the glucagon-like peptides.J Clin Invest. 2017; 127: 4217-4227
- Follistatins in glucose regulation in healthy and obese individuals.Diabetes Obes Metab. 2019; 21: 683-690
- Improvement in cardiovascular indices after Roux-en-Y gastric bypass or sleeve gastrectomy for morbid obesity.Obes Surg. 2013; 23: 31-38
- Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide secretion are associated with Roux-en-Y gastric bypass but not adjustable gastric banding.Surg Obes Relat Dis. 2007; 3: 597-601
- The effect of laparoscopic gastric banding surgery on plasma levels of appetite-control, insulinotropic, and digestive hormones.Obes Surg. 2008; 18: 1089-1096
- Potential hormone mechanisms of bariatric surgery.Curr Obes Rep. 2017; 6: 253-265
- The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones.Peptides. 2016; 77: 28-37
- Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes.J Clin Endocrinol Metab. 2010; 95: 4072-4076
- Predictive value of gut peptides in T2D remission: randomized controlled trial comparing metabolic gastric bypass, sleeve gastrectomy and greater curvature plication.Obes Surg. 2017; 27: 2235-2245
- Comparative effects of Roux-en-Y gastric bypass and sleeve gastrectomy on glucose homeostasis and incretin hormones in obese type 2 diabetic patients: a one-year prospective study.Horm Metab Res. 2016; 48: 312-317
- Changes in glycemia, insulin and gut hormone responses to a slowly ingested solid low-carbohydrate mixed meal after laparoscopic gastric bypass or band surgery.Int J Obes (Lond). 2017; 41: 706-713
- Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans.Obes Surg. 2014; 24: 241-252
- Gut hormones, early dumping and resting energy expenditure in patients with good and poor weight loss response after Roux-en-Y gastric bypass.Int J Obes (Lond). 2013; 37: 1452-1459
- Gastric bypass surgery may improve beta cell apoptosis with ghrelin overexpression in patients with BMI >/= 32.5 kg/m(2.).Obes Surg. 2014; 24: 561-571
- Effect of laparoscopic sleeve gastrectomy on fasting gastrointestinal, pancreatic, and adipose-derived hormones and on non-esterified fatty acids.Obes Surg. 2017; 27: 399-407
- Early improvement in glycemic control after bariatric surgery and its relationships with insulin, GLP-1, and glucagon secretion in type 2 diabetic patients.Obes Surg. 2011; 21: 896-901
- Glucagon-like peptide 1/glucagon receptor dual agonism reverses obesity in mice.Diabetes. 2009; 58: 2258-2266
- No guts, no loss: toward the ideal treatment for obesity in the twenty-first century.Front Endocrinol (Lausanne). 2018; 9: 442
- Oxyntomodulin increases energy expenditure in addition to decreasing energy intake in overweight and obese humans: a randomised controlled trial.Int J Obes (Lond). 2006; 30: 1729-1736
- Native oxyntomodulin has significant glucoregulatory effects independent of weight loss in obese humans with and without type 2 diabetes.Diabetes. 2018; 67: 1105-1112
- Insights on glicentin, a promising peptide of the proglucagon family.Biochem Med (Zagreb). 2017; 27: 308-324
- Fasting circulating glicentin increases after bariatric surgery.Obes Surg. 2017; 27: 1581-1588
- Gastrectomy with Roux-en-Y reconstruction as a lean model of bariatric surgery.Surg Obes Relat Dis. 2018; 14: 562-568
- Efficacy and safety of LY3298176, a novel dual GIP and GLP-1 receptor agonist, in patients with type 2 diabetes: a randomised, placebo-controlled and active comparator-controlled phase 2 trial.Lancet. 2018; 392: 2180-2193
- A novel dual glucagon-like peptide and glucagon receptor agonist SAR425899: results of randomized, placebo-controlled first-in-human and first-in-patient trials.Diabetes Obes Metab. 2018; 21: 120-128
Published online: October 28, 2019
Accepted: October 1, 2019
Received: September 18, 2019
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