The Gut Hormone Response Following Roux-en-Y Gastric Bypass: Cross-sectional and Prospective Study

被引:60
作者
Pournaras, Dimitrios J. [1 ,2 ]
Osborne, Alan [1 ]
Hawkins, Simon C. [1 ]
Mahon, David [1 ]
Ghatei, Mohammad A. [2 ]
Bloom, Steve R. [2 ]
Welbourn, Richard [1 ]
le Roux, Carel W. [2 ]
机构
[1] Musgrove Pk Hosp, Dept Bariatr Surg, Taunton TA1 5DA, Somerset, England
[2] Univ London Imperial Coll Sci Technol & Med, Dept Metab Med, London W12 0NN, England
关键词
Roux-en-Y gastric bypass; RYGB; Gut hormones; Peptide YY; Glucagon-like peptide-1; GLP-1; MORBIDLY OBESE SUBJECTS; GLUCAGON-LIKE PEPTIDE-1; WEIGHT-LOSS; BARIATRIC SURGERY; BILIOPANCREATIC DIVERSION; GLUCOSE; GHRELIN; INCRETIN; APPETITE; RELEASE;
D O I
10.1007/s11695-009-9989-1
中图分类号
R61 [外科手术学];
学科分类号
摘要
Bariatric surgery is the most effective treatment option for obesity, and gut hormones are implicated in the reduction of appetite and weight after Roux-en-Y gastric bypass. Although there is increasing interest in the gut hormone changes after gastric bypass, the long-term changes have not been fully elucidated. Thirty-four participants were studied cross-sectionally at four different time points, pre-operatively (n = 17) and 12 (n = 6), 18 (n = 5) and 24 months (n = 6) after laparoscopic Roux-en-Y gastric bypass. Another group of patients (n = 6) were studied prospectively (18-24 months). All participants were given a standard 400 kcal meal after a 12-h fast, and plasma levels of peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) were correlated with changes in appetite over 3 h using visual analogue scores. The post-operative groups at 12, 18 and 24 months had a higher post-prandial PYY response compared to pre-operative (p < 0.05). This finding was confirmed in the prospective study at 18 and 24 months. There was a trend for increasing GLP-1 response at 18 and 24 months, but this did not reach statistical significance (p = 0.189) in the prospective study. Satiety was significantly reduced in the post-operative groups at 12, 18 and 24 months compared to pre-operative levels (p < 0.05). Roux-en-Y gastric bypass causes an enhanced gut hormone response and increased satiety following a meal. This response is sustained over a 24-month period and may partly explain why weight loss is maintained.
引用
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页码:56 / 60
页数:5
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