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Gastrin Secretion After Bariatric Surgery—Response to a Protein-Rich Mixed Meal Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy: a Pilot Study in Normoglycemic Women

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Abstract

Background

Recent investigations have linked elevated gastrin levels to the improvement of type 2 diabetes mellitus (T2DM). Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are effective treatments for T2DM, but it is not known if this is related to postoperative alterations of gastrin secretion.

Methods

Twenty women previously operated with RYGB or SG and 13 female controls were enrolled and evaluated for body mass index, lipids, C-peptide, HbA1c, and anti-H. pylori IgG. Glucose, gastrin, insulin, and glucagon-like peptide 1 (GLP-1) concentrations were measured before and 30, 60, 90, and 120 min after ingestion of a protein-rich mixed meal.

Results

Six participants primarily selected were excluded due to usage of proton pump inhibitors, positive H.pylori IgG, or history of T2DM, yielding the following groups: RYGB (n = 9), SG (n = 8), and controls (n = 10). There were no differences in age, body mass index, HbA1c, or C-peptide levels between groups. RYGB had significantly lower area under the curve (AUC) for glucose during the test compared to controls (p = 0.013). RYGB showed lower serum gastrin levels compared to SG and controls (p < 0.05 for all). There was a non-significant increased gastrin release in SG compared to controls (p = 0.091). For SG and controls, there was a negative correlation between glucose and gastrin response (p = 0.0043).

Conclusion

Gastrin secretion is diminished after RYGB. Hypergastrinemia was not present after SG, but a tendency of enhanced gastrin secretion was observed. These findings require further investigation in prospective studies.

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Acknowledgments

This study would not have been feasible if not for the gastrin RIA analyses performed by biomedical laboratory scientist (BLS) Brit Schulze and BLS Anne Eleanor Kristensen. We would like to thank the staff at the Clinical Research Facility and Department of Medical Biochemistry, St. Olavs Hospital, Trondheim University Hospital for their professional and designated contribution in this study. Finally, we would like to thank the staff at the Department of Surgery and the Department of Medical Biochemistry at Namsos Hospital, Nord-Trøndelag Health trust, for the welcoming attitude and hardworking spirit throughout this experiment. This study has been funded internally by the Centre for Obesity and Innovation (ObeCe) and the Norwegian National Advisory Unit on Advanced Laparoscopic Surgery (NSALK), St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; the Department of Cancer Research and Molecular Medicine (IKM), Norwegian University of Science and Technology (NTNU), Trondheim, Norway, and the Department of Surgery Namsos Hospital, Nord Trøndelag Health Trust, Namsos, Norway.

Author information

Authors and Affiliations

  1. Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, N-7491, Trondheim, Norway

    Eivind Grong, Bjørn Munkvold, Bård Erik Kulseng, Helge L. Waldum & Ronald Mårvik

  2. Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Ingerid Brænne Arbo

  3. Department of Gastroenterology and Hepatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

    Helge L. Waldum

  4. Centre for Obesity Research and Innovation, HMN (ObeCe), St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

    Bård Erik Kulseng & Ronald Mårvik

  5. Department of Surgery, Namsos Hospital, Nord Trøndelag Health Trust, Namsos, Norway

    Hallvard Græslie

  6. Department of Gastrointestinal Surgery and Norwegian National Advisory Unit on Advanced Laparoscopic Surgery (NSALK), St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

    Ronald Mårvik

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  1. Eivind Grong
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Corresponding author

Correspondence to Eivind Grong.

Ethics declarations

The study was approved by the Regional Ethics Committee for medical research (REK 2013/2168). Informed consent was obtained from all individual participants included in the study on the test day. All procedures performed in the studies involving human participants were in accordance with the ethical standards of the regional national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflicts of Interest

MS Eivind Grong, MD Hallvard Græslie, BLS Bjørn Munkvoll, BLS Ingerid Brænne Arbo, MD Bård Kulseng, MD Helge L. Waldum and MD Ronald Mårvik have no conflicts of interest or financial ties to disclose.

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Grong, E., Græslie, H., Munkvold, B. et al. Gastrin Secretion After Bariatric Surgery—Response to a Protein-Rich Mixed Meal Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy: a Pilot Study in Normoglycemic Women. OBES SURG 26, 1448–1456 (2016). https://doi.org/10.1007/s11695-015-1985-z

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