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Post-prandial anorexigenic gut peptide, appetite and glucometabolic responses at different eating rates in obese patients undergoing laparoscopic sleeve gastrectomy

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Abstract

Although different hypotheses have been proposed, the underlying mechanism(s) of the weight loss induced by laparoscopic sleeve gastrectomy (LSG) is still unknown. The aim of this study was to determine whether eating the same meal at different rates (fast vs. slow feeding) evokes different post-prandial anorexigenic gut peptide responses in ten obese patients undergoing LSG. Circulating levels of GLP-1, PYY, glucose, insulin and triglycerides were measured before and 3 months after LSG. Visual analogue scales were used to evaluate the subjective feelings of hunger and satiety. Irrespective of the operative state, either fast or slow feeding did not stimulate GLP-1 release (vs. 0 min); plasma levels of PYY were increased (vs. 0 min) by fast and slow feeding only after LSG. There were no differences in post-prandial levels of GLP-1 when comparing fast to slow feeding or pre-to-post-operative state. Plasma levels of PYY after fast or slow feeding were higher in post, rather than pre-operative state, with no differences when comparing PYY release after fast and slow feeding. Hunger and satiety were decreased and increased, respectively, (vs. 0 min) by food intake. Fast feeding evoked a higher satiety than slow feeding in both pre- and post-operative states, with no differences in hunger. In both pre- and post-operative states, there were similar responses for hunger and satiety after food intake. Finally, LSG improved insulin resistance after either fast or slow feeding. These (negative) findings would suggest a negligible contribution of the anorexigenic gut peptide responses in LSG-induced weight loss.

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Acknowledgments

The authors wish to thank students from the School of Medicine, University of Milan Bicocca, Monza, Italy, and the dieticians and the nursing staff working at the Division of Internal Medicine, San Gerardo Hospital, University of Milan Bicocca, Monza, Italy, for their skilful assistance during the execution of the experiments.

Authors’ contributions

Antonello E Rigamonti, Angela I Pincelli and Alessandro Sartorio designed the study and wrote the clinical protocol. Angela I Pincelli, Maria Cristina Rocco, Mario Perotti and Maria Grazia Crippa enrolled the subjects and performed the experiments together with Silvia Bini and Vincenzo Cimino. Surgical evaluation and laparascopic sleeve gastrectomy were performed by Diego Massimini and Vittorio Giardini. Silvia Bini, Antonella Saluzzi and Vincenzo Cimino elaborated the database and, together with Marco Casati, performed the analysis of all biochemical parameters. Antonello E Rigamonti analysed data and, together with Angela I Pincelli and Alessandro Sartorio, wrote the manuscript. Silvia Bini and Nicoletta Marazzi contributed to data interpretation and discussion writing. All Authors contributed to the manuscript revision.

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, University of Milan, via Vanvitelli, 32, 20129, Milan, Italy

    Antonello Emilio Rigamonti & Silvia Bini

  2. Division of Internal Medicine, San Gerardo Hospital, University of Milan Bicocca, Monza, Italy

    Maria Cristina Rocco, Maria Grazia Crippa, Antonella Saluzzi, Mario Perotti, Vincenzo Cimino, Guido Grassi & Angela Ida Pincelli

  3. Division of Bariatric Surgery, San Gerardo Hospital, University of Milan Bicocca, Monza, Italy

    Vittorio Giardini & Diego Massimini

  4. Laboratory of Chemical and Clinical Analyses, San Gerardo Hospital, University of Milan Bicocca, Monza, Italy

    Marco Casati

  5. Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-endocrinological Research, Milan, Verbania, Italy

    Nicoletta Marazzi & Alessandro Sartorio

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  1. Antonello Emilio Rigamonti
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  14. Angela Ida Pincelli
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Correspondence to Antonello Emilio Rigamonti.

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Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical approval

All procedures performed in the present study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Funding

The study was partially supported by Progetti di Ricerca Corrente, Istituto Auxologico Italiano, IRCCS, Milan, Italy.

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

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Rigamonti, A.E., Bini, S., Rocco, M.C. et al. Post-prandial anorexigenic gut peptide, appetite and glucometabolic responses at different eating rates in obese patients undergoing laparoscopic sleeve gastrectomy. Endocrine 55, 113–123 (2017). https://doi.org/10.1007/s12020-016-0933-6

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