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Are the Changes in Gastrointestinal Hormone Secretion Necessary for the Success of Bariatric Surgery? A Critical Review of the Literature

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Abstract

Ghrelin, glucagon-like peptide-1 (GLP-1), and peptide YY (PYY) are involved in energy balance regulation and glucose homeostasis. Obesity is characterized by lower fasting levels and blunted postprandial responses of ghrelin, GLP-1, and possibly PYY. Both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been shown to increase postprandial GLP-1 and PYY levels. Human studies have shown that enhanced postprandial GLP-1 and PYY release are associated with favorable weight loss outcomes after RYGB. However, studies in knockout mice have shown that GI hormones are not required for the primary metabolic effects of bariatric surgery. Here, we summarize the complex interaction between obesity, bariatric surgery, and GI hormones in order to determine the exact role of GI hormones in the success of bariatric surgery.

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Authors and Affiliations

  1. Intensive Care Unit, Saint Andrew’s General Hospital, 26335, Patras, Greece

    Charalampos Lampropoulos

  2. Division of Endocrinology, Department of Internal Medicine, School of Medicine, University of Patras, 26504, Rio, Greece

    Theodoros Alexandrides

  3. Department of General Surgery, Saint Andrew’s General Hospital, 26335, Patras, Greece

    Stylianos Tsochatzis

  4. Department of General Surgery, General University Hospital of Patras, 26504, Rio, Greece

    Dimitrios Kehagias

  5. Division of Bariatric and Metabolic Surgery, Department of Surgery, General University Hospital of Patras, 26504, Rio, Greece

    Ioannis Kehagias

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  1. Charalampos Lampropoulos
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  2. Theodoros Alexandrides
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  3. Stylianos Tsochatzis
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  4. Dimitrios Kehagias
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  5. Ioannis Kehagias
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Correspondence to Charalampos Lampropoulos.

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Key Points

• Ghrelin, GLP-1, and PYY are involved in energy balance regulation.

• RYGB and SG cause a marked increase in postprandial GLP-1 and PYY levels.

• Enhanced postprandial GLP-1 release is associated with success of RYGB.

• Causality and the importance of this association have not been established.

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Lampropoulos, C., Alexandrides, T., Tsochatzis, S. et al. Are the Changes in Gastrointestinal Hormone Secretion Necessary for the Success of Bariatric Surgery? A Critical Review of the Literature. OBES SURG 31, 4575–4584 (2021). https://doi.org/10.1007/s11695-021-05568-7

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  • DOI: https://doi.org/10.1007/s11695-021-05568-7

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