GLP-1: A Mediator of the Beneficial Metabolic Effects of Bariatric Surgery?

Physiology ◽  
2015 ◽  
Vol 30 (1) ◽  
pp. 50-62 ◽  
Author(s):  
Sean Manning ◽  
Andrea Pucci ◽  
Rachel L. Batterham

There has been increasing interest in the role that gut hormones may play in contributing to the physiological changes produced by certain bariatric procedures, such as Roux-en-Y gastric bypass and sleeve gastrectomy. Here, we review the evidence implicating one such gut hormone, glucagon-like peptide-1, as a mediator of the metabolic benefits of these two procedures.

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 878
Author(s):  
Arnaud Bernard ◽  
Johanne Le Beyec-Le Bihan ◽  
Loredana Radoi ◽  
Muriel Coupaye ◽  
Ouidad Sami ◽  
...  

The aim of this study was to explore the impact of bariatric surgery on fat and sweet taste perceptions and to determine the possible correlations with gut appetite-regulating peptides and subjective food sensations. Women suffering from severe obesity (BMI > 35 kg/m2) were studied 2 weeks before and 6 months after a vertical sleeve gastrectomy (VSG, n = 32) or a Roux-en-Y gastric bypass (RYGB, n = 12). Linoleic acid (LA) and sucrose perception thresholds were determined using the three-alternative forced-choice procedure, gut hormones were assayed before and after a test meal and subjective changes in oral food sensations were self-reported using a standardized questionnaire. Despite a global positive effect of both surgeries on the reported gustatory sensations, a change in the taste sensitivity was only found after RYGB for LA. However, the fat and sweet taste perceptions were not homogenous between patients who underwent the same surgery procedure, suggesting the existence of two subgroups: patients with and without taste improvement. These gustatory changes were not correlated to the surgery-mediated modifications of the main gut appetite-regulating hormones. Collectively these data highlight the complexity of relationships between bariatric surgery and taste sensitivity and suggest that VSG and RYGB might impact the fatty taste perception differently.


2020 ◽  
Author(s):  
Cristina Fiorani ◽  
Sophie R. Coles ◽  
Myutan Kulendran ◽  
Emma Rose McGlone ◽  
Marcus Reddy ◽  
...  

Abstract Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been shown to improve metabolic comorbidities as well as quality of life (QoL) in the obese population. The vast majority of previous studies have investigated the metabolic effects of bariatric surgery and there is a dearth of studies examining long-term QoL outcomes post bariatric surgery. The outcomes of 43 patients who underwent bariatric surgery were prospectively assessed, using BAROS questionnaires to quantify QoL and metabolic status pre-operatively, at 1 year and at 8 years. Total weight loss and comorbidity resolution were similar between RYGB and SG. The RYGB cohort experienced greater QoL improvement from baseline and had higher BAROS scores at 8 years. RYGB may provide more substantial and durable long-term benefits as compared to SG.


2020 ◽  
Vol 13 ◽  
pp. 117955142090584 ◽  
Author(s):  
Annie Hasib

The ever-increasing prevalence of obesity and Type 2 diabetes has necessitated the development of newer and more effective approaches for achieving efficient glycemic control and weight loss. Conventional treatment methods often result in weight gain, further deteriorating the already impaired metabolic control in people with obesity/Type 2 diabetes. Alleviation of obesity and diabetes achieved after bariatric surgeries highlight the therapeutic importance of gut-brain axis and entails development of more patient-friendly approaches replicating the positive metabolic effects of bariatric surgery. Given the potential involvement of several gut hormones in the success of bariatric surgery, the therapeutic importance of synergistic interaction between these hormones for improved metabolism cannot be ignored. Many unimolecular multiagonist peptides are in preclinical and clinical trials as they maximize the combinatorial metabolic efficacy by concurrent activation of multiple gut hormone receptors. This review summarizes the ongoing developments of multiagonist peptides as novel therapeutic approaches against obesity-diabetes.


2021 ◽  
Author(s):  
Oleg Kornyushin ◽  
Dmitry Sonin ◽  
Alexander Polozov ◽  
Vitaly Masley ◽  
Nika Bulavinova ◽  
...  

Abstract Bariatric surgery (BS) improves outcomes in patients with myocardial infarction (MI). Here we tested the hypothesis that BS-mediated reduction in fatal MI could be attributed to its infarct-limiting effect. Wistar rats were randomized into five groups: control (CON), sham (SHAM), Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and ileotransposition (IT). Ten weeks later, animals were subjected to 30-min myocardial ischemia plus 120-min reperfusion. Infarct size (IS) and no-reflow zone (NRZ) were determined histochemically. Fasting plasma levels of glucagon-like peptide-1 (GLP-1), leptin, ghrelin, and insulin were measured using ELISA. Compared with SHAM, RYGB and SG reduced IS by 22% (p = 0.011) and 10% (p = 0.027), and NRZ by 38% (p = 0.01) and 32% (p = 0.004), respectively. IT failed to reduce IS and NRZ. GLP1 level was increased in the SG and RYGB groups compared with CON. In both the SG and RYGB, leptin level was decreased compared with CON and SHAM. In the SG group, ghrelin level was lower than that in the CON and SHAM. Insulin levels were not different between groups. In conclusion, RYGB and SG increased myocardial tolerance to ischemia–reperfusion injury of non-obese, non-diabetic rats, and their infarct-limiting effect is associated with decreased leptin and ghrelin levels and increased GLP-1 level.


2014 ◽  
Vol 11 (4) ◽  
pp. 64
Author(s):  
Teona Albertovna Shvangiradze

Orlistat, which reduces fat absorption by inhibiting intestinal lipase is a registered drug for obesity pharmacotherapy. Meta-analyzes indicate various positive metabolic effects of orlistat, including improvements in glucose and lipid metabolism, lowering both systolic and diastolic blood pressure. It is assumed that orlistat can reduce postprandial satiety by inhibiting the release of intestinal hormones (incretins), especially glucagon-like peptide-1 (GLP-1). Impact analysis of the secretion of incretins, with prolonged use of orlistat was conducted. The aim of the study M.Olszanecka-Glinianowicz et al. was to evaluate the effect of 8 weeks of treatment with orlistat as part of a weight loss program for preprandialnye levels of peptide YY and GLP-1.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Oleg Kornyushin ◽  
Dmitry Sonin ◽  
Alexander Polozov ◽  
Vitaly Masley ◽  
Nika Bulavinova ◽  
...  

AbstractBariatric surgery (BS) improves outcomes in patients with myocardial infarction (MI). Here we tested the hypothesis that BS-mediated reduction in fatal MI could be attributed to its infarct-limiting effect. Wistar rats were randomized into five groups: control (CON), sham (SHAM), Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and ileotransposition (IT). Ten weeks later, animals were subjected to 30-min myocardial ischemia plus 120-min reperfusion. Infarct size (IS) and no-reflow area were determined histochemically. Fasting plasma levels of glucagon-like peptide-1 (GLP-1), leptin, ghrelin, and insulin were measured using ELISA. Compared with SHAM, RYGB and SG reduced IS by 22% (p = 0.011) and 10% (p = 0.027), and no-reflow by 38% (p = 0.01) and 32% (p = 0.004), respectively. IT failed to reduce IS and no-reflow. GLP-1 level was increased in the SG and RYGB groups compared with CON. In both the SG and RYGB, leptin level was decreased compared with CON and SHAM. In the SG group, ghrelin level was lower than that in the CON and SHAM. Insulin levels were not different between groups. In conclusion, RYGB and SG increased myocardial tolerance to ischemia–reperfusion injury of non-obese, non-diabetic rats, and their infarct-limiting effect is associated with decreased leptin and ghrelin levels and increased GLP-1 level.


2013 ◽  
Vol 304 (4) ◽  
pp. G413-G419 ◽  
Author(s):  
David P. Sonne ◽  
Kristine J. Hare ◽  
Pernille Martens ◽  
Jens F. Rehfeld ◽  
Jens J. Holst ◽  
...  

Preclinical studies suggest that gallbladder emptying, via bile acid-induced activation of the G protein-coupled receptor TGR5 in intestinal L cells, may play a significant role in the secretion of the incretin hormone glucagon-like peptide-1 (GLP-1) and, hence, postprandial glucose homeostasis. We examined the secretion of gut hormones in cholecystectomized subjects to test the hypothesis that gallbladder emptying potentiates postprandial release of GLP-1. Ten cholecystectomized subjects and 10 healthy, age-, gender-, and body mass index-matched control subjects received a standardized fat-rich liquid meal (2,200 kJ). Basal and postprandial plasma concentrations of glucose, insulin, C-peptide, glucagon, GLP-1, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-2 (GLP-2), cholecystokinin (CCK), and gastrin were measured. Furthermore, gastric emptying and duodenal and serum bile acids were measured. We found similar basal glucose concentrations in the two groups, whereas cholecystectomized subjects had elevated postprandial glucose excursions. Cholecystectomized subjects had reduced postprandial concentrations of duodenal bile acids, but preserved postprandial plasma GLP-1 responses, compared with control subjects. Also, cholecystectomized patients exhibited augmented fasting glucagon. Basal plasma CCK concentrations were lower and peak concentrations were higher in cholecystectomized patients. The concentrations of GIP, GLP-2, and gastrin were similar in the two groups. In conclusion, cholecystectomized subjects had preserved postprandial GLP-1 responses in spite of decreased duodenal bile delivery, suggesting that gallbladder emptying is not a prerequisite for GLP-1 release. Cholecystectomized patients demonstrated a slight deterioration of postprandial glycemic control, probably because of metabolic changes unrelated to incretin secretion.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 153-OR
Author(s):  
HENRI HONKA ◽  
ANAS M. AL ZUBAIDI ◽  
AMALIA GASTALDELLI ◽  
RALPH A. DEFRONZO ◽  
MARZIEH SALEHI

Author(s):  
Heba H. Zayed ◽  
Karim Sabry ◽  
Yasser M Abdelraouf ◽  
Wessam M. Salah ◽  
Ingy Abdel Wahab ◽  
...  

Our Study Aimed: To investigate the effect of laparoscopic sleeve gastrectomy (LSG) on obese T2DM patients, its effect in remission of diabetes and role of gastrointestinal Glucagon like peptide 1(GLP1) and Peptide tyrosine tyrosine (PYY) hormones. Metabolic surgery should be recommended as an option in type 2 diabetic patients (T2DM) with body mass index (BMI) ≥40 Kg/m2, in patients who have BMI ≥35 Kg/m2 and in selected patients with BMI < 35 Kg/m2, if not achieving diabetes control with maximum tolerated anti-hyperglycemic treatment. Methods: 30 T2DM patients with BMI ≥ 40 kg/m2 underwent laparoscopic sleeve gastrectomy after full clinical evaluation, routine blood tests, glucagon like peptide 1, Peptide tyrosine tyrosine (fasting, 0.5-hour post-mixed meal test (MMT) serum levels) and upper GIT endoscopy. Follow-up visits were at 3, 6 and 9 months postoperatively to evaluate body weight, BMI and glycated hemoglobin (HbA1C) and at 18th month for confirmation of diabetes remission. Gut hormones were measured at 15 days and 9 months postoperatively. Results: (53.3%) of patients had partial remission of T2DM according to HbA1C remission criteria. There was significant increase in fasting and post-MMT levels of peptide tyrosine tyrosine, glucagon like peptide 1 postoperatively. The only independent predictors for remission of T2DM were the baseline serum low density lipoprotein cholesterol (LDL-Ch), duration of diabetes, preoperative post MMT Peptide tyrosine tyrosine plasma level, serum thyroid stimulating hormone (TSH) and age. Conclusions: laparoscopic sleeve gastrectomy can induce partial remission of diabetes in younger patients who had shorter duration of diabetes, higher level of preoperative post-MMT peptide tyrosine tyrosine, lower levels of preoperative serum LDL-Ch and thyroid stimulating hormone.


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