Obesity Surgery

, Volume 22, Issue 7, pp 1084–1096

Changes in Gastrointestinal Hormone Responses, Insulin Sensitivity, and Beta-Cell Function Within 2 Weeks After Gastric Bypass in Non-diabetic Subjects

Authors

    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • S. C. Olesen
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • C. Dirksen
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • N. B. Jørgensen
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • K. N. Bojsen-Møller
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • U. Kielgast
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • D. Worm
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • T. Almdal
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • L. S. Naver
    • Department of Gastroenterology, Hvidovre HospitalUniversity of Copenhagen
  • L. E. Hvolris
    • Department of Gastroenterology, Hvidovre HospitalUniversity of Copenhagen
  • J. F. Rehfeld
    • Department of Clinical Biochemistry, RigshospitaletUniversity of Copenhagen
  • B. S. Wulff
    • Diabetes Biology Novo Nordisk
  • T. R. Clausen
    • Diabetes Biology Novo Nordisk
  • D. L. Hansen
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
  • J. J. Holst
    • The Novo Nordisk Foundation Center for Basic Metabolic Research, Department of Biomedical SciencesUniversity of Copenhagen
  • S. Madsbad
    • Department of Endocrinology 541, Hvidovre HospitalUniversity of Copenhagen
Clinical Research

DOI: 10.1007/s11695-012-0621-4

Cite this article as:
Jacobsen, S.H., Olesen, S.C., Dirksen, C. et al. OBES SURG (2012) 22: 1084. doi:10.1007/s11695-012-0621-4

Abstract

Background

Roux-en-Y gastric bypass (RYGB) surgery causes profound changes in secretion of gastrointestinal hormones and glucose metabolism. We present a detailed analysis of the early hormone changes after RYGB in response to three different oral test meals designed to provide this information without causing side effects (such as dumping).

Methods

We examined eight obese non-diabetic patients before and within 2 weeks after RYGB. On separate days, oral glucose tolerance tests (25 or 50 g glucose dissolved in 200 mL of water) and a liquid mixed meal test (200 mL 300 kcal) were performed. We measured fasting and postprandial glucose, insulin, C-peptide, glucagon, total and intact glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-2 (GLP-2), peptide YY3-36 (PYY), cholecystokinin (CCK), total and active ghrelin, gastrin, somatostatin, pancreatic polypeptide (PP), amylin, leptin, free fatty acids (FFA), and registered postprandial dumping. Insulin sensitivity was measured by homeostasis model assessment of insulin resistance.

Results

Fasting glucose, insulin, ghrelin, and PYY were significantly decreased and FFA was elevated postoperatively. Insulin sensitivity increased after surgery. The postprandial response increased for C-peptide, GLP-1, GLP-2, PYY, CCK, and glucagon (in response to the mixed meal) and decreased for total and active ghrelin, leptin, and gastrin, but were unchanged for GIP, amylin, PP, and somatostatin after surgery. Dumping symptoms did not differ before and after the operation or between the tests.

Conclusions

Within 2 weeks after RYGB, we found an increase in insulin secretion and insulin sensitivity. Responses of appetite-regulating intestinal hormones changed dramatically, all in the direction of reducing hunger.

Keywords

Gastric bypass Gastrointestinal hormones Insulin resistance Incretins Appetite-regulating hormone Obesity

Copyright information

© Springer Science + Business Media, LLC 2012