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Weight Regain After Gastric Bypass: Influence of Gut Hormones

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Abstract

Background

The Roux-en-Y gastric bypass (RYGB) is the gold standard bariatric operation. However, a major concern in late follow-up is the substantial weight regain. Understanding the role of gastrointestinal hormone secretion in this situation is relevant.

Methods

The aim of the present study was to evaluate the influence of gastrointestinal hormones comparing postprandial secretion of ghrelin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1), and leptin between patients with weight regain and those with favorable weight control. Twenty-four patients with follow-up from 27 to 59 months were divided into two groups according to sustained weight loss: group A (14 patients) had sustained weight losses, and group B (10 patients) had significant weight regain. Basal serum levels of ghrelin, GIP, GLP-1, and leptin after fasting and 30, 60, 90, and 120 min after a standard meal were measured.

Results

There was no difference in the ghrelin secretion. There was a difference in the GIP secretion, with a higher percentage increase in 30 min in group A (330 % × 192.2 %; p = 0.01). There were also differences in the GLP-1 secretion, with higher increases in absolute (p = 0.03) and percentage values after 30 min in group A (124 % × 46.5 %; p = 0.01). There was also a difference between baseline leptin values, with higher levels in group B (p = 0.02).

Conclusions

The secretion of gut hormones in patients with weight regain after RYGB is different from that in patients with satisfactory weight outcome. After meal stimulation, reduced levels of GIP and GLP-1 may indicate the influence of gut hormones in the process of weight regain.

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Acknowledgments

We thank Mrs. Marta Rodrigues, librarian, for the bibliographical references, Ms. Priscila Caproni, biologist, for organization of data and laboratory tests collection, and Prof. Julio Pereira and Dr. Márcio Diniz for the statistical analyses.

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Authors and Affiliations

  1. Department of Digestive Surgery, University of São Paulo School of Medicine, Av. Arnolfo Azevedo 208, São Paulo, SP, 05673-010, Brazil

    Marco Aurelio Santo, Daniel Riccioppo, Denis Pajecki, Flavio Kawamoto, Roberto de Cleva, Leila Antonangelo, Lia Marçal & Ivan Cecconello

  2. Central Laboratory of Hospital das Clínicas, São Paulo, Brazil

    Leila Antonangelo & Lia Marçal

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  1. Marco Aurelio Santo
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  2. Daniel Riccioppo
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  3. Denis Pajecki
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  8. Ivan Cecconello
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Correspondence to Marco Aurelio Santo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Santo, M.A., Riccioppo, D., Pajecki, D. et al. Weight Regain After Gastric Bypass: Influence of Gut Hormones. OBES SURG 26, 919–925 (2016). https://doi.org/10.1007/s11695-015-1908-z

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  • DOI: https://doi.org/10.1007/s11695-015-1908-z

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