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Similar Gut Hormone Secretions Two Years After One Anastomosis Gastric Bypass and Roux-en-Y Gastric Bypass: a Pilot Study

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Abstract

Objectives

One-anastomosis gastric bypass (OAGB) is as effective as Roux-en-Y gastric bypass (RYGB) regarding weight loss and diabetes remission. However, there are no data on gut hormone secretions after OAGB. The aim of this study was to compare fasting and postprandial secretions of gut and pancreatic hormones in OAGB versus RYGB patients.

Design and Methods

Twenty-nine patients, 16 OAGB- and 13 RYGB-operated, underwent a liquid mixed-meal tolerance test at 2 years’ post-surgery. Blood was sampled before and 15, 30, 60, 90, and 120 min after meal for plasma measurement of glucose, C-peptide, insulin, glucagon, GLP-1, GIP, GLP-2, PYY, and ghrelin.

Results

Percentage of total weight loss 2 years post-surgery were -33.9 ± 1.8% for OAGB and -31.2 ± 1.6% for RYGB (p = 0.6). Four patients with persistent diabetes were excluded for further analysis. Fasting and postprandial glucose levels (peaks and area under curve values) were similar between groups. HOMA index was lower in the OAGB group (0.8 ± 0.1 vs 1.3 ± 0.2 in RYGB, p < 0.05). Levels of C-peptide (or insulin) measured at 30 min were significantly lower in OAGB vs RYGB patients (6.9 ± 0.5 vs 9.7 ± 1.1 µg/l, p < 0.05). No difference was observed between OAGB and RYGB groups for GLP-1, GLP-2, PYY, or ghrelin postprandial secretions, but GIP tended to be lower in OAGB vs RYGB patients (756 ± 155 vs 1100 ± 188 pg/ml for postprandial peak concentrations, p = 0.06).

Conclusions

This is the first clinical study showing that OAGB procedure, like RYGB, results in high postprandial secretions of gut hormones, in particular GLP-1.

Trial Registration

Clinical Trials NCT03482895

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Abbreviations

RYGB:

Roux-en-Y gastric bypass

OAGB:

One anastomosis gastric bypass

EEC:

Enteroendocrine cells

BPL:

Biliopancreatic limb

BMI:

Body mass index

EBMIL:

Excess body mass index loss

HOMA-IR:

Homeostatic Model Assessment of Insulin Resistance

T2D:

Type 2 diabetes

AUC:

Area under curve

GLP-1 or GLP-2:

Glucagon-like-peptide-1 or glucagon-like-peptide-2

PYY:

Peptide YY

GIP:

Gastric inhibitory peptide

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Acknowledgements

The sponsor was Assistance Publique – Hôpitaux de Paris (APHP) (Direction de la Recherche Clinique et de l’Innovation), represented by the Clinical Research Unit (Hôpital Européen Georges Pompidou, Paris, head: Pr Sandrine KATSAHIAN). We are very grateful to the team of the Clinical Investigation Center (Hôpital Européen Georges Pompidou, Paris) where the patients were monitored for the meal test, and to Melinda Zehani and the technical staff of the endocrine biochemistry department (Hôpital Pitié Salpêtrière, Paris) who realized some of the routine dosages.

Funding

This study was funded by the ANTADIR grant of the Société Francophone de Nutrition Clinique et Métabolique (SFNCM), Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance Publique Hôpitaux de Paris (APHP).

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Author notes

  1. Claire Carette and Johanne Le Beyec contributed equally.

Authors and Affiliations

  1. AP-HP, Hôpital Européen Georges-Pompidou, Nutrition, APHP.Centre - Université de Paris, Paris, France

    David De Bandt, Claire Rives-Lange, Sébastien Czernichow & Claire Carette

  2. AP-HP, Hôpital Européen Georges-Pompidou, Unité de Recherche Clinique, APHP.Centre - Université de Paris, Paris, France

    Yvann Frigout

  3. INSERM, Centre d’Investigation Clinique 1418, Hôpital Européen Georges-Pompidou, APHP.Centre - Université de Paris, Paris, France

    Yvann Frigout, Damien Bergerot, Anne Blanchard & Claire Carette

  4. INSERM, UMR 1149 Centre de Recherche Sur L’Inflammation, Université de Paris, Paris, France

    Maude Le Gall & Johanne Le Beyec

  5. AP-HP, Hôpital Pitié-Salpêtrière, Biochimie Endocrinienne Et Oncologique, APHP.6 - Sorbonne Université, Paris, France

    Jean-Marc Lacorte & Johanne Le Beyec

  6. AP-HP, Hôpital Européen Georges-Pompidou, Chirurgie digestive, APHP.Centre - Université de Paris, Paris, France

    Jean-Marc Chevallier & Tigran Poghosyan

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  1. David De Bandt
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Contributions

DDB, CC, and JLB designed the research; JMC and TB operated the patients; DDB, CRL, and CC recruited the patients; DDB, YF, DB, CC, and JLB conducted the research and collected the data; DDB, MLG, CC, and JLB analyzed the data. DDB, CC, and JLB wrote the manuscript; all authors read and approved the final manuscript.

Corresponding author

Correspondence to Johanne Le Beyec.

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Ethics Approval

All procedures performed in studies 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 or comparable ethical standards.

Informed Consent

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

Conflict of Interest

The authors declare no competing interests.

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Key Points

• Total weight loss was similar 2 years after OAGB and RYGB.

• The HOMA-IR was lower in OAGB-operated patients 2 years after surgery.

• GLP-1, GLP-2, and PYY postprandial secretions were similar 2 years after OAGB and RYGB.

• GIP postprandial secretion tended to be lower in OAGB- vs RYGB-operated patients.

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De Bandt, D., Rives-Lange, C., Frigout, Y. et al. Similar Gut Hormone Secretions Two Years After One Anastomosis Gastric Bypass and Roux-en-Y Gastric Bypass: a Pilot Study. OBES SURG 32, 757–762 (2022). https://doi.org/10.1007/s11695-021-05837-5

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  • DOI: https://doi.org/10.1007/s11695-021-05837-5

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