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GLP-1: 10-year follow-up after Roux-en-Y gastric bypass

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Abstract

Purpose

Glucagon-like peptide-1 (GLP-1) is a hormone widely studied in the short-term postoperative follow-up of Roux-en-Y gastric bypass due to its elevation and association with improvement of the glucose metabolism, but there are few studies in 10 years after RYGB follow-up with the same patient.

Methods

Twenty morbidity obesity patients were submitted to RYGB; these patients were divided into two groups: normal glucose-tolerant morbidly obese patients (NGT) 11 patients and abnormal glucose metabolism morbidly obese patients (AGM) 9 patients. Oral glucose tolerance test (OGTT) was done during four different periods: T1 (first evaluation), T2 (pre-surgery), T3 (9 months after surgery) and T4 (10 years after surgery).

Results

Groups were matched for age and gender, and as NGT and AGM had BMI of 46.31 ± 5.03 kg/m2 and 50.87 ± 10.31 kg/m2. After 10 years of RYGB, they were obesity grade I with BMI for NGT 32.45 ± 4.99 kg/m2 and AGM 34.85 ± 4.46 kg/m2. Plasma glucose levels decreased NGT group at T4 period had a significant reduction at 120 min after OGTT for NGT 55.49 ± 17.15 mg/dL (p˂0.001). Insulin levels changed from T1 to T4 for the NGT group. GLP-1 curves were statistically different between the NGT and AGM groups. The AGM group had a higher mean for GLP-1 secretion at T4 period and at 30 min of OGTT 63.85 ± 37.98 pmol/L when compared to NGT 50.73 ± 24.82 pmol/L with AGM > NGT with p˂0.001.

Conclusion

Evaluation of the same patient during 4 different periods shows that, even with weight regain, after 10-years of RYGB high levels of GLP-1 remained which can be associated with metabolic improvement especially at the NGT group.

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Acknowledgements

We thank all those who somehow contributed to this project. We specially thank Daniel Henrique do Amaral Corrêa, Ph.D., for the bibliographical references, organization, and statistical analysis.

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Authors and Affiliations

  1. Department of Internal Medicine, School of Medical Sciences, PO, University of Campinas-UNICAMP, Campinas, SP, 13083-970, Brazil

    Camila Carvalho

  2. Department of Internal Medicine, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil

    Aglécio Luiz de Souza, Gisele Almeida Batista, Louise Franciscato Trivelato Duran, Débora Puzzi Fernandes, Viviane Bressane Claus Molina, Raquel Gonçalves, Joelma Silvia Giorgetti & Sarah Monte Alegre

  3. Surgery Department, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil

    Elintom Adami Chaim

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  1. Camila Carvalho
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Contributions

Conception or design of the work: Camila Carvalho, Elintom Adami Chaim, and Sarah Monte Alegre. Data collection: Camila Carvalho, Joelma Silvia Giorgetti, Viviane Bressane Claus Molina, Gisele Almeida Batista, Louise Franciscato Trivelato Duran, and Débora Puzzi Fernandes. Data analysis and interpretation: Aglécio Luiz de Souza, Sarah Monte Alegre, and Camila Carvalho. Drafting the article: Camila Carvalho, Elintom Adami Chaim, Sarah Monte Alegre, and Raquel Gonçalves. Critical revision of the article: Camila Carvalho, Elintom Dami Chaim, Sarah Monte Alegre, and Aglécio Luiz de Souza. Final approval of the version to be published: Camila Carvalho, Aglécio Luiz de Souza, Gisele Almeida Batista, Louise Franciscato Trivelato Duran, Débora Puzzi Fernandes, Viviane Bressane Claus Molina, Raquel Gonçalves, Joelma Silvia Giorgetti1, Elintom Adami Chaim, and Sarah Monte Alegre.

Corresponding author

Correspondence to Camila Carvalho.

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Ethics approval

The study had protocol approved by the Research Ethics Committee of University of Campinas-UNICAMP, School of the Faculty of Medical Sciences (FCM-UNICAMP) number 31989314.3.0000.5404.

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All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. This study was approved by the institutional review board.

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Carvalho, C., de Souza, A.L., Batista, G.A. et al. GLP-1: 10-year follow-up after Roux-en-Y gastric bypass. Langenbecks Arch Surg 407, 559–568 (2022). https://doi.org/10.1007/s00423-021-02341-3

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