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. 2015 Sep;10(3):458-65.
doi: 10.5114/wiitm.2015.54003. Epub 2015 Sep 11.

Changes in levels of selected incretins and appetite-controlling hormones following surgical treatment for morbid obesity

Piotr Major  1 , Maciej Matłok  1 , Michał Pędziwiatr  1 , Marcin Migaczewski  1 , Anna Zub-Pokrowiecka  1 , Dorota Radkowiak  1 , Marek Winiarski  1 , Anna Zychowicz  1 , Danuta Fedak  2 , Andrzej Budzyński  1
Affiliations

Changes in levels of selected incretins and appetite-controlling hormones following surgical treatment for morbid obesity

Piotr Major et al. Wideochir Inne Tech Maloinwazyjne. 2015 Sep.

Abstract

Introduction: The hormonal brain-gut axis is a crucial element in appetite control and the response to surgical treatment for super obesity. However, mechanisms underlying the metabolic response to surgical treatment for morbid obesity are still not clearly specified.

Aim: To evaluate and compare the effects of surgical treatment for super obesity by laparoscopic sleeve gastrectomy (LSG) and by laparoscopic Roux-en-Y gastric bypass (LRYGB) on selected incretins and appetite-controlling hormones.

Material and methods: Thirty-five patients were enrolled in a prospective study. Laparoscopic sleeve gastrectomy was performed in 45.8% of patients, and LRYGB in the remaining 54.2% of patients. Before the procedure fasting blood serum was collected from patients and preserved, to determine levels of selected incretins and brain-gut hormones: glucagon-like peptide 1 (GLP-1), peptide YY (PYY), leptin, and ghrelin.

Results: Twenty-eight patients came to a follow-up visit 12 months after the surgery. In these patients selected parameters were determined again. The percentage weight loss was 58.8%. The ghrelin levels had decreased, and no statistically significant difference was observed between the two procedures. After both surgical procedures a statistically significant reduction in the leptin level was also observed. Peptide YY levels statistically significantly increased in the whole studied group. The GLP-1 level increased after the surgical procedure. However, the observed change was not statistically significant.

Conclusions: Both treatment methods result in modification of secretion patterns for selected gastrointestinal hormones, and this was considered to be a beneficial effect of bariatric treatment. The laparoscopic sleeve gastrectomy, being a procedure resulting in a metabolic response, seems to be an equally effective method for treatment of super obesity and comorbidities as the laparoscopic gastric bypass.

Keywords: Roux-en-Y gastric bypass (RYGB); bariatric surgery; ghrelin; glucagon-like peptide 1; laparoscopic sleeve gastrectomy (LSG); leptin.

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Figures

Figure 1
Figure 1
Study plan (flow chart)
Figure 2
Figure 2
Changes in activity levels of selected incretins and gastrointestinal tract hormones following surgical treatment for super obesity
Figure 3
Figure 3
Change in ghrelin levels following a given type of surgical procedure
Figure 4
Figure 4
Change in leptin levels following a given type of surgical procedure
Figure 5
Figure 5
Change in PYY levels following a given type of surgical procedure
Figure 6
Figure 6
Change in GLP-1 levels following a given type of surgical procedure
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