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The role of the gastric fundus in glycemic control

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Abstract

Purpose

Ghrelin, one of the most studied gut hormones, is mainly produced by the gastric fundus. Abundant evidence exists from preclinical and clinical studies underlining its contribution to glucose regulation. In the following narrative review, the role of the gastric fundus in glucose regulation is summarized and we investigate whether its resection enhances glycemic control.

Methods

An electronic search was conducted in the PubMed® database and in Google Scholar® using a combination of medical subject headings (MeSH). We examined types of metabolic surgery, including, in particular, gastric fundus resection, either as part of laparoscopic sleeve gastrectomy (LSG) or modified laparoscopic gastric bypass with fundus resection (LRYGBP + FR), and the contribution of ghrelin reduction to glucose regulation.

Results

Fourteen human studies were judged to be eligible and included in this narrative review. Reduction of ghrelin levels after fundus resection might be related to early glycemic improvement before significant weight loss is achieved. Long-term data regarding the role of ghrelin reduction in glucose homeostasis are sparse.

Conclusion

The exact role of ghrelin in achieving glycemic control is still ambiguous. Data from human studies reveal a potential contribution of ghrelin reduction to early glycemic improvement, although further well-designed studies are needed.

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Authors and Affiliations

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

    Dimitrios Kehagias & Francesk Mulita

  2. Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, 26504, Rio, Greece

    Neoklis Georgopoulos

  3. Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital of Patras, 26504, Rio, Greece

    Ioannis Habeos

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

    Charalampos Lampropoulos

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

    Ioannis Kehagias

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Correspondence to Dimitrios Kehagias.

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Kehagias, D., Georgopoulos, N., Habeos, I. et al. The role of the gastric fundus in glycemic control. Hormones 22, 151–163 (2023). https://doi.org/10.1007/s42000-023-00429-7

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