Non-responders After Gastric Bypass Surgery for Morbid Obesity: Peptide Hormones and Glucose Homeostasis

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Sima, Eduardo,Ph.D.1975-Uppsala universitet,Gastrointestinalkirurgi (author)

Non-responders After Gastric Bypass Surgery for Morbid Obesity : Peptide Hormones and Glucose Homeostasis

Article/chapterEnglish2019

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2019-07-22
Springer Science and Business Media LLC,2019
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LIBRIS-ID:oai:DiVA.org:uu-400343
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-400343URI
https://doi.org/10.1007/s11695-019-04089-8DOI

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Language:English
Summary in:English

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INTRODUCTION: About 20% of patients operated with Roux-en-Y gastric bypass (RYGBP) experience poor long-term weight result. This study compared levels of leptin and gut hormones in long-term weight responders with non-responders after RYGBP. In a subgroup analysis, hormone levels were assessed in T2DM (type 2 diabetes mellitus) and normoglycemic participants.METHODS: Insulin, glucose, leptin, acyl-ghrelin, total PYY, active GLP-1, and GIP were measured during an oral glucose tolerance test (OGTT) in post-RYGBP subjects: 22 non-responders (BMI 40.6 ± 6.0 kg/m2 after an excess BMI loss [EBMIL] of 26.0 ± 15.9%) and 18 responders (BMI 29.5 ± 3.5 kg/m2 after an EBMIL of 74.9 ± 18.2%). Subjects were matched for preoperative age, BMI, and years of follow-up. Measures of glucose homeostasis were calculated, and body composition was measured.RESULTS: Fat mass-adjusted fasting leptin correlated negatively with %EBMIL (r = - 0.57, p < 0.01). Non-responders presented higher levels of leptin during the OGTT. Leptin decreased and ghrelin returned to baseline levels earlier in non-responders. Despite having higher insulin resistance than responders, non-responders demonstrated similar OGTT responses of GLP-1, GIP, and PYY. T2DM participants demonstrated lower GLP-1 levels than normoglycemic participants of similar weight.CONCLUSION: Fasting leptin is associated with weight result after RYGBP, and hormonal responses to a glucose oral load might work towards promoting obesity in long-term non-responders after RYGBP. Poor long-term weight result and glycemic status after RYGBP are each associated with differences in peptide hormone levels.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Gastroenterologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Gastroenterology and Hepatology hsv//eng
Gastric bypass
Incretins
Leptin
Long-term results
Weight loss
Medicinsk vetenskap
Medical Science

Added entries (persons, corporate bodies, meetings, titles ...)

Webb, Dominic-LucUppsala universitet,Gastroenterologi/hepatologi(Swepub:uu)domwe127 (author)
Hellström, Per M.,1954-Uppsala universitet,Gastroenterologi/hepatologi(Swepub:uu)perhe742 (author)
Sundbom, MagnusUppsala universitet,Gastrointestinalkirurgi(Swepub:uu)magsundb (author)
Uppsala universitetGastrointestinalkirurgi (creator_code:org_t)

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In:Obesity Surgery: Springer Science and Business Media LLC29:12, s. 4008-40170960-89231708-0428

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