A Meta-Analysis of GLP-1 After Roux-En-Y Gastric Bypass: Impact of Surgical Technique and Measurement Strategy
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Roux-en-Y gastric bypass (RYGB) is an effective treatment for diabetes. Glucagon-like peptide-1 (GLP-1) is a gut hormone that is important to glucose homeostasis.
This study aimed to assess GLP-1 level and its predictors after RYGB.
The study design was a meta-analysis. The data sources were MEDLINE, EMBASE, Web of Science, and the Cochrane Databases. The study selection composed of studies with pre- and post-RYGB levels. The main outcomes were as follows: Primary outcome was the change in postprandial GLP-1 levels after RYGB. Secondary outcomes included the changes in fasting glucose, fasting insulin, and fasting GLP-1 levels after RYGB. Meta-regression to determine predictors of changes in GLP-1 levels was performed. Outcomes were reported using Hedge’s g.
Twenty-four studies with 368 patients were included. Postprandial GLP-1 levels increased after RYGB (Hedge’s g = 1.29, p < 0.0001), while fasting GLP-1 did not change (p = 0.23). Peak postprandial GLP-1 levels gave the most consistent results (I 2 = 9.11). Fasting glucose and insulin levels decreased after RYGB (p < 0.0001).
Roux limb length was a significant predictor for amount of GLP-1 increase (β = − 0.01, p = 0.02). Diabetes status, amount of weight loss, length of biliopancreatic limb, and time of measurement were not significant predictors (p > 0.05).
Postprandial GLP-1 levels increase after RYGB, while fasting levels remain unchanged. Shorter Roux limb length is associated with greater increase in postprandial GLP-1, which may lead to better glycemic control in this population.
KeywordsRYGB GLP-1 Incretin Diabetes Metabolic Bariatric Mechanism Obesity
Roux-En-Y Gastric Bypass
Body Mass Index
Non-alcoholic Fatty Liver Disease
Swedish Obese Subjects
Type 2 Diabetes Mellitus
Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently
Area Under The Curve
Oral Glucose Tolerance Test
Risk Of Bias In Non-Randomized Studies—Of Interventions
Newcastle-Ottawa Quality Assessment Scale
Randomized Controlled Trial
Farnesoid X Receptor
No financial or material support was received for this research project.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval Statement
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed Consent Statement
Does not apply.
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