scholarly journals Do Gut Hormones Contribute to Weight Loss and Glycaemic Outcomes after Bariatric Surgery?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 762
Author(s):  
Dimitris Papamargaritis ◽  
Carel W. le Roux
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Glucose Homeostasis ◽  
Hormone Secretion ◽  
Eating Behaviour ◽  
Early Period ◽  
Specific Inhibitor ◽  
Gut Hormones ◽  
Current Evidence ◽  
Gut Hormone

Bariatric surgery is an effective intervention for management of obesity through treating dysregulated appetite and achieving long-term weight loss maintenance. Moreover, significant changes in glucose homeostasis are observed after bariatric surgery including, in some cases, type 2 diabetes remission from the early postoperative period and postprandial hypoglycaemia. Levels of a number of gut hormones are dramatically increased from the early period after Roux-en-Y gastric bypass and sleeve gastrectomy—the two most commonly performed bariatric procedures—and they have been suggested as important mediators of the observed changes in eating behaviour and glucose homeostasis postoperatively. In this review, we summarise the current evidence from human studies on the alterations of gut hormones after bariatric surgery and their impact on clinical outcomes postoperatively. Studies which assess the role of gut hormones after bariatric surgery on food intake, hunger, satiety and glucose homeostasis through octreotide use (a non-specific inhibitor of gut hormone secretion) as well as with exendin 9–39 (a specific glucagon-like peptide-1 receptor antagonist) are reviewed. The potential use of gut hormones as biomarkers of successful outcomes of bariatric surgery is also evaluated.

scholarly journals Food preferences and underlying mechanisms after bariatric surgery

2015 ◽  
Vol 74 (4) ◽  
pp. 419-425 ◽  
Author(s):  
Preeshila Behary ◽  
Alexander D. Miras
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Eating Behaviour ◽  
Food Preferences ◽  
Gut Hormones ◽  
High Energy ◽  
Sweet Taste ◽  
Current Evidence ◽  
Fatty Food

Bariatric surgery leads to significant long-term weight loss, particularly Roux-en-Y gastric bypass (RYGB). The mechanisms underlying weight loss have not been fully uncovered. The aim of this review is to explore the changes in food preferences, as a novel mechanism contributing to weight loss, and also focus on the underlying processes modulating eating behaviour after bariatric surgery. Patients after gastric bypass are less hungry and prefer healthier food options. They develop an increased acuity to sweet taste, which is perceived as more intense. The appeal of sweet fatty food decreases, with functional MRI studies showing a corresponding reduction in activation of the brain reward centres to high-energy food cues. Patients experiencing post-ingestive symptoms with sweet and fatty food develop conditioned aversive behaviours towards the triggers. Gut hormones are elevated in RYGB and have the potential to influence the taste system and food hedonics. Current evidence supports a beneficial switch in food preferences after RYGB. Changes within the sensory and reward domain of taste and the development of post-ingestive symptoms appear to be implicated. Gut hormones may be the mediators of these alterations and therefore exploiting this property might prove beneficial for designing future obesity treatment.

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

2017 ◽  
Vol 49 (11) ◽  
pp. 816-825 ◽  
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.

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

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
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.

scholarly journals Effect of the Natural Sweetener Xylitol on Gut Hormone Secretion and Gastric Emptying in Humans: A Pilot Dose-Ranging Study

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 174
Author(s):  
Anne Christin Meyer-Gerspach ◽  
Jürgen Drewe ◽  
Wout Verbeure ◽  
Carel W. le Roux ◽  
Ludmilla Dellatorre-Teixeira ◽  
...  
Keyword(s):  
Uric Acid ◽  
Gastric Emptying ◽  
Blood Lipids ◽  
Tap Water ◽  
Hormone Secretion ◽  
Gastrointestinal Symptoms ◽  
Gut Hormones ◽  
Double Blind ◽  
Gut Hormone ◽  
Dose Dependent

Sugar consumption is associated with a whole range of negative health effects and should be reduced and the natural sweetener xylitol might be helpful in achieving this goal. The present study was conducted as a randomized, placebo-controlled, double-blind, cross-over trial. Twelve healthy, lean volunteers received intragastric solutions with 7, 17 or 35 g xylitol or tap water on four separate days. We examined effects on: gut hormones, glucose, insulin, glucagon, uric acid, lipid profile, as well as gastric emptying rates, appetite-related sensations and gastrointestinal symptoms. We found: (i) a dose-dependent stimulation of cholecystokinin (CCK), active glucagon-like peptide-1 (aGLP-1), peptide tyrosine tyrosine (PYY)-release, and decelerated gastric emptying rates, (ii) a dose-dependent increase in blood glucose and insulin, (iii) no effect on motilin, glucagon, or glucose-dependent insulinotropic peptide (GIP)-release, (iv) no effect on blood lipids, but a rise in uric acid, and (v) increased bowel sounds as only side effects. In conclusion, low doses of xylitol stimulate the secretion of gut hormones and induce a deceleration in gastric emptying rates. There is no effect on blood lipids and only little effect on plasma glucose and insulin. This combination of properties (low-glycemic sweetener which stimulates satiation hormone release) makes xylitol an attractive candidate for sugar replacement.

scholarly journals Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies

2017 ◽  
Vol 76 (11) ◽  
pp. 1870-1882 ◽  
Author(s):  
Sabrina M Nielsen ◽  
Else M Bartels ◽  
Marius Henriksen ◽  
Eva E Wæhrens ◽  
Henrik Gudbergsen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Longitudinal Studies ◽  
Randomised Trial ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Short Term ◽  
Quality Of Evidence

ObjectivesWeight loss is commonly recommended for gout, but the magnitude of the effect has not been evaluated in a systematic review. The aim of this systematic review was to determine benefits and harms associated with weight loss in overweight and obese patients with gout.MethodsWe searched six databases for longitudinal studies, reporting the effect of weight loss in overweight/obese gout patients. Risk of bias was assessed using the tool Risk of Bias in Non-Randomised Studies of Interventions. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation.ResultsFrom 3991 potentially eligible studies, 10 were included (including one randomised trial). Interventions included diet with/without physical activity, bariatric surgery, diuretics, metformin or no intervention. Mean weight losses ranged from 3 kg to 34 kg. Clinical heterogeneity in study characteristics precluded meta-analysis. The effect on serum uric acid (sUA) ranged from −168 to 30 μmol/L, and 0%–60% patients achieving sUA target (<360 μmol/L). Six out of eight studies (75%) showed beneficial effects on gout attacks. Two studies indicated dose–response relationship for sUA, achieving sUA target and gout attacks. At short term, temporary increased sUA and gout attacks tended to occur after bariatric surgery.ConclusionsThe available evidence is in favour of weight loss for overweight/obese gout patients, with low, moderate and low quality of evidence for effects on sUA, achieving sUA target and gout attacks, respectively. At short term, unfavourable effects may occur. Since the current evidence consists of a few studies (mostly observational) of low methodological quality, there is an urgent need to initiate rigorous prospective studies (preferably randomised controlled trials).Systematic review registrationPROSPERO, CRD42016037937.

scholarly journals P-O01 A patient education video to support the management of post-gastrectomy / oesophagectomy syndromes

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Geoffrey Roberts ◽  
Andrew Stone ◽  
Nicola Sunderland ◽  
Sam Grimes ◽  
Frank Reimann ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Patient Education ◽  
Hormone Secretion ◽  
Eating Behaviour ◽  
Physiological Basis ◽  
Upper Gi ◽  
Gut Hormone ◽  
Patient Representatives ◽  
Upper Gi Cancer ◽  
Nutritional Strategies

Abstract Background Oesophagectomy and gastrectomy result in profound and life-long changes in eating behaviour and appetite, and significant post-prandial symptoms. Despite decades of research, and recent advantages in the understanding of gut physiology, medical approaches to post-resectional patient care remain limited. The mainstay of treatment is patient education. Using clinical and lab-based studies, we investigated the effects of altered gut hormone secretion in patients after surgery for oesophageal and gastric cancer. We then produced a partially animated patient information video to better equip our patients to manage their altered alimentation. Methods The scientific background to the video was previously presented at AUGIS, and published. Studies included examination of eating behaviour, post-prandial symptoms, glucose homeostasis, gut hormone profiles and intestinal transcriptomic / peptidomic changes in a cohort of patients after oesophagectomy and gastrectomy. The movie storyboard and script were written by a team of surgeons, dietitians, patient representatives, clinical scientists and communications specialists. The goal was to communicate the physiological basis of altered eating in post-operative patients and appropriate nutritional strategies. Results The video is now freely available on Vimeo at: https://vimeo.com/356892336 It is in routine use for pre- and post-operative patient education. Conclusions Multimedia patient education is a useful tool to help manage the late effects of upper GI cancer treatment.

scholarly journals A Pilot Study of Gut-Brain Signaling After Octreotide Therapy for Unintentional Weight Loss After Esophagectomy

2020 ◽  
Vol 106 (1) ◽  
pp. e204-e216
Author(s):  
Conor F Murphy ◽  
Nicholas Stratford ◽  
Neil G Docherty ◽  
Brendan Moran ◽  
Jessie A Elliott ◽  
...  
Keyword(s):  
Weight Loss ◽  
Pilot Study ◽  
Food Intake ◽  
Eating Behavior ◽  
Hormone Secretion ◽  
Symptom Burden ◽  
Octreotide Lar ◽  
Gut Hormone ◽  
Ad Libitum ◽  
Brain Reward

Abstract Background Recurrence-free patients after esophageal cancer surgery face long-term nutritional consequences, occurring in the context of an exaggerated postprandial gut hormone response. Acute gut hormone suppression influences brain reward signaling and eating behavior. This study aimed to suppress gut hormone secretion and characterize reward responses and eating behavior among postesophagectomy patients with unintentional weight loss. Methods This pilot study prospectively studied postoperative patients with 10% or greater body weight loss (BWL) beyond 1 year who were candidates for clinical treatment with long-acting octreotide (LAR). Before and after 4 weeks of treatment, gut hormone secretion, food cue reactivity (functional magnetic resonance imaging), eating motivation (progressive ratio task), ad libitum food intake, body composition, and symptom burden were assessed. Results Eight patients (7 male, age: mean ± SD 62.8 ± 9.4 years, postoperative BWL: 15.5 ± 5.8%) participated. Octreotide LAR did not significantly suppress total postprandial plasma glucagon-like peptide-1 response at 4 weeks (P = .08). Postprandial symptom burden improved after treatment (Sigstad score median [range]: 12 [2-28] vs 8 [3-18], P = .04) but weight remained stable (pre: 68.6 ± 12.8 kg vs post: 69.2 ± 13.4 kg, P = .13). There was no significant change in brain reward system responses, during evaluation of high-energy or low-energy food pictures, nor their appeal rating. Moreover, treatment did not alter motivation to eat (P = .41) nor ad libitum food intake(P = .46). Conclusion The protocol used made it feasible to characterize the gut-brain axis and eating behavior in this cohort. Inadequate suppression of gut hormone responses 4 weeks after octreotide LAR administration may explain the lack of gut-brain pathway alterations. A higher dose or shorter interdose interval may be required to optimize the intervention.

scholarly journals Multiagonist Unimolecular Peptides for Obesity and Type 2 Diabetes: Current Advances and Future Directions

2020 ◽  
Vol 13 ◽  
pp. 117955142090584 ◽  
Author(s):  
Annie Hasib
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Hormone Receptors ◽  
Gut Hormones ◽  
Metabolic Effects ◽  
Therapeutic Approaches ◽  
Obesity And Diabetes ◽  
Gut Hormone ◽  
Prevalence Of Obesity

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.

scholarly journals Peripheral Pathways in the Food-Intake Control towards the Adipose-Intestinal Missing Link

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Hugo Mendieta Zerón ◽  
Ma. Victoria Domínguez García ◽  
María del Socorro Camarillo Romero ◽  
Miriam V. Flores-Merino
Keyword(s):  
Diabetes Mellitus ◽  
Genetic Basis ◽  
Physiological State ◽  
Hormone Secretion ◽  
Gut Hormones ◽  
Diabetic Patients ◽  
Early Presentation ◽  
Gut Hormone ◽  
Unknown Factor

In the physiological state a multitude of gut hormones are released into the circulation at the same time depending on the quality and quantity of the diet. These hormones interact with receptors at various points in the “gut-brain axis” to affect short-term and intermediate-term feelings of hunger and satiety. The combined effects of macronutrients on the predominant gut hormone secretion are still poorly understood. Besides, adipokines form an important part of an “adipoinsular axis” dysregulation which may contribute toβ-cell failure and hence to type 2 diabetes mellitus (T2DM). Even more, gestational diabetes mellitus (GDM) and T2DM seem to share a genetic basis. In susceptible individuals, chronic exaggerated stimulation of the proximal gut with fat and carbohydrates may induce overproduction of an unknown factor that causes impairment of incretin production and/or action, leading to insufficient or untimely production of insulin, so that glucose intolerance develops. The bypass of the duodenum and jejunum might avoid a putative hormone overproduction in the proximal foregut in diabetic patients that might counteract the action of insulin, while the early presentation of undigested or incompletely digested food to the ileum may anticipate the production of hormones such as GLP1, further improving insulin action.

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