Gut Hormone Profiles Following Bariatric Surgery Favor an Anorectic State, Facilitate Weight Loss, and Improve Metabolic Parameters

Methods of treating obesity, such as changes in lifestyle, physical activity, restrictive diets, and psychotherapy, are not sufficient. Currently, it is considered that in the case of patients who meet the eligibility criteria for surgery, the treatment of choice should be bariatric surgery. The aim of this study was to assess the weight loss and metabolic changes in a group of adults with obesity undergoing bariatric surgery. The study involved 163 patients whose body mass index (BMI) exceeded 40 or 35 kg/m2, concurrent with at least one metabolic sequelae. In 120 of the cases (74%), sleeve gastrectomy was used; in 35 (21%), gastric banding was used; and in 8 (5%), laparoscopic Roux-en-Y gastric bypass was used. Metabolic parameters such as total cholesterol, LDL-cholesterol (low-density lipoprotein cholesterol), HDL-cholesterol (high-density lipoprotein cholesterol), triglycerides, and glucose were measured preoperatively and postoperatively, as well as the creatinine, creatine kinase (CK-MB), and leptin activity. In patients undergoing bariatric surgery, a significant decrease in excess weight (p < 0.001) was observed at all the analyzed time points, compared to the pre-surgery value. Weight loss after surgery was associated with a significant improvement in glycemia (109.6 ± 48.0 vs. 86.6 ± 7.9 mg/dL >24 months after surgery; p = 0.003), triglycerides (156.9 ± 79.6 vs. 112.7 ± 44.3 mg/dL >24 months after surgery; p = 0.043) and leptin (197.50 ± 257.3 vs. 75.98 ± 117.7 pg/mL 12 months after surgery; p = 0.0116) concentration. The results of the research confirm the thesis on the effectiveness of bariatric surgery in reducing excess body weight and improving metabolic parameters in patients with extreme obesity.

Download Full-text

The Role of Bile Acids in Gut-Hormone-Induced Weight Loss After Bariatric Surgery: Implications for Appetite Control and Diabetes

Handbook of Behavior, Food and Nutrition ◽

10.1007/978-0-387-92271-3_85 ◽

2011 ◽

pp. 1317-1330 ◽

Cited By ~ 2

Author(s):

Rachel E. Roberts ◽

Jamsaid Alaghband-Zadeh ◽

Carel W. Le Roux

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Bile Acids ◽

Appetite Control ◽

Gut Hormone

Download Full-text

Long-Term Weight Loss and Metabolic Syndrome Remission after Bariatric Surgery: The Effect of Sex, Age, Metabolic Parameters and Surgical Technique – A 4-Year Follow-Up Study

Obesity Facts ◽

10.1159/000503753 ◽

2019 ◽

Vol 12 (6) ◽

pp. 639-652 ◽

Cited By ~ 5

Author(s):

Vanessa Guerreiro ◽

João Sérgio Neves ◽

Daniela Salazar ◽

Maria João Ferreira ◽

Sofia Castro Oliveira ◽

...

Keyword(s):

Bariatric Surgery ◽

Metabolic Syndrome ◽

Weight Loss ◽

Surgical Technique ◽

Metabolic Parameters ◽

Follow Up Study

Download Full-text

Changes in metabolic parameters and glomerular filtration rate in patients with morbid obesity after bariatric surgery

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.06.000674 ◽

2020 ◽

Vol 92 (6) ◽

pp. 53-59

Author(s):

Sonya S. Gussaova ◽

Irina N. Bobkova ◽

Yury I. Yashkov ◽

Natalya S. Bordan ◽

Ekaterina V. Stavrovskaya ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Weight Loss ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Metabolic Parameters ◽

Mini Gastric Bypass ◽

Combined Operations ◽

Before And After

Aim. To study the effect of weight loss in the short term after bariatric surgery (BO) on metabolic parameters and glomerular filtration rate (GFR) in patients with morbid obesity. Materials and methods. We studied 40 adult (over 18 years) patients with morbid obesity who underwent bariatric surgery. Metabolic indices and calculated GFR according to the CKD-EPI formula in patients before and after bariatric surgery were compared. Results. In the whole group of operated patients, the average body mass index (BMI) after surgery decreased from 45.8 to 30.5 kg/m2. In 11 (92%) patients with impaired carbohydrate metabolism, remission of diabetes mellitus was achieved and sugar-lowering drugs were canceled. In patients with baseline GFR90 ml/min/1.73 m2 after surgery, there is a tendency towards a decrease in GFR, probably due to a decrease in hyperfiltration. In patients with baseline GFR90 ml/min/1.73 m2 after surgery, a statistically significant increase in the level of GFR was noted. The greater metabolic efficacy of combined operations (mini-gastric bypass, biliopancreatic diversion) in relation to the correction of carbohydrate and fat metabolism was revealed. Conclusion. Obesity is a modifiable risk factor for decreased kidney function and the progression of chronic kidney disease. Bariatric surgery is an effective treatment for morbid obesity. The study proved the positive effect of weight loss after BO on renal function, including by improving the course of diseases associated with obesity.

Download Full-text

Cancer Cachexia: The Comparative Mechanisms of Weight Loss after Esophagectomy and Bariatric Surgery

OBM Integrative and Complementary Medicine ◽

10.21926/obm.icm.2102017 ◽

2020 ◽

Vol 06 (02) ◽

pp. 1-1

Author(s):

David J Tansey ◽

◽

Carel W le Roux ◽

◽

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Oesophageal Cancer ◽

Survival Rates ◽

Cancer Surgery ◽

Unintentional Weight Loss ◽

Curative Intent ◽

Gut Hormone ◽

Esophagogastric Cancer ◽

Hormone Signalling

Oesophageal cancer is the ninth most common cancer and the sixth most common cause of cancer deaths worldwide [1]. Over the past number of years, due to earlier diagnosis and better treatment, we are seeing improvements in the survival rates of oesophageal cancer, with more patients living longer post-esophagectomy surgery. Unintentional weight loss is a common unintended feature seen in patients post-esophagectomy done with curative intent. Many recent studies have demonstrated the links between the pathophysiology of the weight loss following esophagogastric cancer surgery and the biological mechanism of weight loss following bariatric surgery. The predominant cause of the weight loss in both circumstances appears to the postoperative alterations in gut hormone signalling. This paper explores these over-lapping gut hormones signalling mechanisms and discusses the use of this increased understanding of hormone signalling to develop potential pharmacologic targets for the management of unintentional weight loss post-esophagogastric cancer surgery.

Download Full-text

Recombinant Human Leptin Does Not Alter Gut Hormone Levels after Gastric Bypass but May Attenuate Sweet Cravings

International Journal of Endocrinology ◽

10.1155/2014/120286 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Rushika Conroy ◽

Gerardo Febres ◽

Donald J. McMahon ◽

Michael O. Thorner ◽

Bruce D. Gaylinn ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Gut Hormones ◽

Liquid Meal ◽

Gut Hormone ◽

Sweet Cravings ◽

The Impact ◽

To Receive ◽

Reduced State

Bariatric surgery improves glucose homeostasis and alters gut hormones partly independent of weight loss. Leptin plays a role in these processes; levels are decreased following bariatric surgery, creating a relative leptin insufficiency. We previously showed that leptin administration in a weight-reduced state after Roux-en-Y gastric bypass (RYGB) caused no further weight loss. Here, we discuss the impact of leptin administration on gut hormones, glucostasis, and appetite. Weight stable women after RYGB were randomized to receive placebo or recombinant human metreleptin (0.05 mg/kg twice daily). At weeks 0 and 16, a liquid meal challenge was performed. Glucose, insulin, C-peptide, GLP-1, PYY, glucagon, and ghrelin (total, acyl, and desacyl) were measured fasting and postprandially. Appetite was assessed using a visual analog scale. Mean post-op period was53±2.3months; mean BMI was34.6±0.2 kg/m2. At 16 weeks, there was no significant change in weight within or between groups. Fasting PYY was significantly different between groups and the leptin group had lower sweets craving at week 16 than the placebo group (P<0.05). No other differences were observed. Leptin replacement does not alter gut hormones or glucostasis but may diminish sweet cravings compared to placebo in this population of post-RYGB women.

Download Full-text

Homeostasis Disrupted and Restored—A Fresh Look at the Mechanism and Treatment of Obesity During COVID-19

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.721956 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jacqueline Dickey ◽

Camelia Davtyan ◽

David Davtyan ◽

Heinrich Taegtmeyer

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Adult Population ◽

The United States ◽

High Rate ◽

Metabolic Parameters ◽

Intermittent Fasting ◽

Metabolic Homeostasis ◽

Target Weight ◽

The Metabolic Syndrome

The prevalence of obesity in the United States approaches half of the adult population. The COVID-19 pandemic endangers the health of obese individuals. In addition, the metabolic syndrome poses a challenge to the health of obese adults. Bariatric surgery and diet restore metabolic homeostasis in obese individuals; however, it is still unclear which strategy is most effective. For example, intermittent fasting improves insulin sensitivity and diet alone decreases visceral adipose tissue at a disproportionately high rate compared to weight loss. Bariatric surgery causes rapid remission of type 2 diabetes and increases incretins for long-term remission of insulin resistance before meaningful weight loss has occurred. Malabsorptive surgeries have provided insight into the mechanism of altering metabolic parameters, but strong evidence to determine the duration of their effects is yet to be established. When determining the best method of weight loss, metabolic parameters, target weight loss, and risk-benefit analysis must be considered carefully. In this review, we address the pros and cons for the optimal way to restore metabolic homeostasis.

Download Full-text

The Role of Gut Hormones in Diet-Induced Weight Change: A Systematic Review

Hormone and Metabolic Research ◽

10.1055/s-0043-115646 ◽

2017 ◽

Vol 49 (11) ◽

pp. 816-825 ◽

Cited By ~ 9

Author(s):

Xue Zhao ◽

Qing Han ◽

Xiaokun Gang ◽

You Lv ◽

Yujia Liu ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Large Scale ◽

Weight Regain ◽

Dietary Intervention ◽

Gut Hormones ◽

Current Evidence ◽

Cochrane Library ◽

Weight Changes ◽

Gut Hormone

AbstractGut hormones are known to play an important role in long-term weight loss maintenance after bariatric surgery. However, the interplay between gut hormones and diet-induced weight changes remains unclear. Our aims were to evaluate the alterations of gut hormones in diet-induced weight loss, weight maintenance, and weight regain periods. Available studies were searched on MEDLINE, EMASE, ClinicalTrials.gov, the Cochrane Library, and Web of science from inception to October 2016. After selection, 16 studies with 656 participants were included. Based on current evidence, we found significant alterations of gut hormones induced by different diets. In weight-loss diets, decreased fasting total PYY, GLP-1, CCK, GIP, PP, and amylin along with increased ghrelin levels were observed in most studies. After weight loss, the persistent decreases of fasting total PYY and GLP-1 levels as well as increased appetite were reported, suggesting the profound impact of altered gut hormones on later weight regain after dietary intervention. The differences between diet-induced changes in gut hormones and other treatments such as bariatric surgery and exercise are also discussed in this review. Although significant alterations of gut hormones were found during weight changes, huge heterogeneity exists in methods and populations. More large-scale studies with elaborate design addressing the gut hormone alterations in dietary weight regulation are required in the future.

Download Full-text