Changes in gastrointestinal hormones and leptin after Roux-en-Y gastric bypass surgery

Lauren M. Beckman, Tiffany R Beckman, Shalamar Sibley, William Thomas, Sayeed Ikramuddin, Todd A. Kellogg, Mohammad A. Ghatei, Stephen R. Bloom, Carel W. Le Roux, Carrie P Earthman

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

Background: Roux-en-Y gastric bypass (RYGB) imparts long-term weight loss, the mechanisms for which are not well understood. Changes in leptin and gastrointestinal (GI) hormones, including glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and ghrelin, may contribute to the relative success of RYGB compared with conventional weight loss methods. This study evaluated changes in GI hormones and leptin post-RYGB. The study also evaluated whether GI hormones differed after a short-term dose of protein or fat. Methods: GLP-1, PYY, ghrelin, and leptin were assessed in 16 women before RYGB and up to 1 year after RYGB. Plasma was collected before and at several times after a short-term equi-caloric dose of protein or fat. Results: GLP-1 area under the curve (AUC) increased at week 6 and 1 year in the fat beverage (FAT-BEV) group compared with baseline. PYY AUC remained elevated at 1 year in the FAT-BEV group. Ghrelin AUC decreased at week 2, week 6, and 1 year in the protein beverage (PRO-BEV) group compared with baseline. Ghrelin AUC was lower in the PRO-BEV group compared with the FAT-BEV group at week 6. Fasted leptin decreased at all visits in both groups and was lower in the FAT-BEV group compared with the PRO-BEV group at 1 year. Conclusions: Changes from baseline were evident for all GI hormones and leptin; some differences were evident soon after surgery (ghrelin, leptin), whereas others were maintained long term (GLP-1, PYY, ghrelin, leptin). In response to a short-term stimulus, protein suppressed ghrelin and fat potently stimulated GLP-1 and PYY. Future work in this area is warranted.

Original languageEnglish (US)
Pages (from-to)169-180
Number of pages12
JournalJournal of Parenteral and Enteral Nutrition
Volume35
Issue number2
DOIs
StatePublished - Mar 1 2011

Keywords

  • gastric bypass
  • gastrointestinal hormones
  • ghrelin
  • glucagon-like peptide 1
  • leptin
  • obesity
  • peptide YY

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