Obesity Surgery

, Volume 27, Issue 3, pp 703–708 | Cite as

GLP-1 and GLP-2 Levels are Correlated with Satiety Regulation After Roux-en-Y Gastric Bypass: Results of an Exploratory Prospective Study

  • Everton CazzoEmail author
  • José Carlos Pareja
  • Elinton Adami Chaim
  • Bruno Geloneze
  • Maria Rita Lazzarini Barreto
  • Daniéla Oliveira Magro
Original Contributions



Changes in satiety regulation are known to play a pivotal role in the weight loss effects of Roux-en-Y gastric bypass (RYGB) and the mechanisms by which these changes occur are not entirely known. There are previous reports of the influence of GLP-1 to cause enhancement of satiation, but in regard to GLP-2, it remains unclear. This study aimed to determine whether there is a correlation between the levels of GLP-1 and GLP-2 and satiety regulation following RYGB.

Materials and Methods

An exploratory prospective cohort study was made which enrolled 11 individuals who underwent RYGB and were followed-up for 12 months. GLP-1 and GLP-2 levels were determined before and after surgery and correlated with visual analogue scale scores for satiety.


GLP-2 AUC after standard meal tolerance test (MTT) was significantly higher following surgery (945.3 ± 449.1 versus 1787.9 ± 602.7; p = 0.0037). Postoperatively, GLP-1 AUC presented a significant negative correlation with the mean score obtained in the first question of the visual analogue scale (“how hungry do you feel?”) (p = 0.008); GLP-2 AUC presented a significant positive correlation with the mean score of the third (“how full do you feel?”) question, and a significant positive correlation with the mean score achieved in the fourth question (“how much do you think you can eat?”), (p = 0.005 and p = 0.042, respectively).


GLP-1 and GLP-2 were significantly correlated with satiety assessment within this sample. Further research is necessary to confirm these findings.


Bariatric surgery Obesity Gastric bypass Satiety response Glucagon-like peptides 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

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

Statement of Human and Animal Rights

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.


  1. 1.
    Karlsson J, Taft C, Rydén A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond). 2007;31(8):1248–61.CrossRefGoogle Scholar
  2. 2.
    Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.CrossRefPubMedGoogle Scholar
  3. 3.
    Angrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery Worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRefPubMedGoogle Scholar
  4. 4.
    Le Roux CW, Aylwin SJ, Batterham RL, et al. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann Surg. 2006;243(1):108–14.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Le Roux CW, Welbourn R, Werling M, et al. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass. Ann Surg. 2007;246(5):780–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Blundell J, de Graaf C, Hulshof T, et al. Appetite control: methodological aspects of the evaluation of foods. Obes Rev. 2010;11(3):251–70.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Flint A, Raben A, Blundell JE, et al. Reproducibility, power and validity of visual analogue scales in assessment of appetite sensations in single test meal studies. Int J Obes Relat Metab Disord. 2000;24(1):38–48.CrossRefPubMedGoogle Scholar
  9. 9.
    de Graaf C. The validity of appetite ratings. Appetite. 1993;21(2):156–60.CrossRefPubMedGoogle Scholar
  10. 10.
    Fobi M, Johnson AP, Bristo LD, et al. The “limiting proximal gastric pouch”: the evolving solution of morbid obesity. J Natl Med Assoc. 1982;74(10):1005–9.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Scholtz S, Goldstone AP, le Roux CW. Changes in reward after gastric bypass: the advantages and disadvantages. Curr Atheroscler Rep. 2015;17(10):61.CrossRefPubMedGoogle Scholar
  12. 12.
    Miras AD, le Roux CW. Mechanisms underlying weight loss after bariatric surgery. Nat Rev Gastroenterol Hepatol. 2013;10(10):575–84.CrossRefPubMedGoogle Scholar
  13. 13.
    Moran TH, Dailey MJ. Intestinal feedback signaling and satiety. Physiol Behav. 2011;105(1):77–81.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Suzuki K, Jayasena CN, Bloom SR. The gut hormones in appetite regulation. J Obes. 2011;2011:528401.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Vahl T, D’Alessio D. Enteroinsular signaling: perspectives on the role of the gastrointestinal hormones glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide in normal and abnormal glucose metabolism. Curr Opin Clin Nutr Metab Care. 2003;6(4):461–8.PubMedGoogle Scholar
  16. 16.
    Rubino F, Marescaux J. Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes: a new perspective for an old disease. Ann Surg. 2004;239(1):1–11.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Rubino F, Gagner M, Gentileschi P, et al. The early effect of the Roux-en-Y gastric bypass on hormones involved in body weight regulation and glucose metabolism. Ann Surg. 2004;240(2):236–42.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Drucker DJ, Yusta B. Physiology and pharmacology of the enteroendocrine hormone glucagon-like peptide-2. Annu Rev Physiol. 2014;76:561–83.CrossRefPubMedGoogle Scholar
  19. 19.
    Geloneze B, Lima MM, Pareja JC, et al. Association of insulin resistance and GLP-2 secretion in obesity: a pilot study. Arq Bras Endocrinol Metabol. 2013;57(8):632–5.CrossRefPubMedGoogle Scholar
  20. 20.
    Gutzwiller JP, Drewe J, Göke B, et al. Glucagon-like peptide-1 promotes satiety and reduces food intake in patients with diabetes mellitus type 2. Am J Physiol. 1999;276(5 Pt 2):R1541–4.PubMedGoogle Scholar
  21. 21.
    Baggio LL, Huang Q, Brown TJ, et al. A recombinant human glucagon-like peptide (GLP)-1-albumin protein (albugon) mimics peptidergic activation of GLP-1 receptor-dependent pathways coupled with satiety, gastrointestinal motility, and glucose homeostasis. Diabetes. 2004;53(9):2492–500.CrossRefPubMedGoogle Scholar
  22. 22.
    Pannacciulli N, Le DS, Salbe AD, et al. Postprandial glucagon-like peptide-1 (GLP-1) response is positively associated with changes in neuronal activity of brain areas implicated in satiety and food intake regulation in humans. Neuroimage. 2007;35(2):511–7.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Gibbons C, Caudwell P, Finlayson G, et al. Comparison of postprandial profiles of ghrelin, active GLP-1, and total PYY to meals varying in fat and carbohydrate and their association with hunger and the phases of satiety. J Clin Endocrinol Metab. 2013;98(5):E847–55.CrossRefPubMedGoogle Scholar
  24. 24.
    Ten Kulve JS, Veltman DJ, van Bloemendaal L, et al. Endogenous GLP-1 mediates postprandial reductions in activation in central reward and satiety areas in patients with type 2 diabetes. Diabetologia. 2015;58(12):2688–98.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Schmidt PT, Näslund E, Grybäck P, et al. Peripheral administration of GLP-2 to humans has no effect on gastric emptying or satiety. Regul Pept. 2003;116(1-3):21–5.CrossRefPubMedGoogle Scholar
  26. 26.
    Sørensen LB, Flint A, Raben A, et al. No effect of physiological concentrations of glucagon-like peptide-2 on appetite and energy intake in normal weight subjects. Int J Obes Relat Metab Disord. 2003;27(4):450–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.State University of Campinas (UNICAMP)CampinasBrazil

Personalised recommendations