Prospective study of gut hormone and metabolic changes after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

Background Laparoscopic sleeve gastrectomy (SG) has surpassed Roux-en-Y gastric bypass (RYGB) as the most prevalent bariatric procedure worldwide. While RYGB and SG demonstrate equivalent short-term weight loss, long-term weight loss tends to be greater after RYGB. Differences in the effect of these...

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Bibliographic Details
Published in:PloS one 2020-07, Vol.15 (7), p.e0236133-e0236133
Main Authors: Arakawa, Rachel, Febres, Gerardo, Cheng, Bin, Krikhely, Abraham, Bessler, Marc, Korner, Judith, Blachier, François
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Blood
Blood levels
Diabetes
Digestive system
Digestive tract
Endocrinology
Energy balance
Gastrectomy
Gastric bypass
Gastrointestinal surgery
Gastrointestinal tract
Ghrelin
Glucagon
Glucagon-like peptide 1
Glucose
Homeostasis
Hormones
Insulin
Laparoscopy
Leptin
Medicine and Health Sciences
Metabolism
Motility
Patient outcomes
Patients
Peptides
Physical Sciences
Physicians
Plasma
Surgeons
Surgery
Sweet taste
Weight control
Weight loss
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Summary:Background Laparoscopic sleeve gastrectomy (SG) has surpassed Roux-en-Y gastric bypass (RYGB) as the most prevalent bariatric procedure worldwide. While RYGB and SG demonstrate equivalent short-term weight loss, long-term weight loss tends to be greater after RYGB. Differences in the effect of these procedures on gastrointestinal hormones that regulate energy homeostasis are felt to partially underlie differences in outcomes. The objective of this study was to prospectively quantify blood levels of gut hormones of energy and glucose homeostasis at one year follow up to delineate possible reasons for greater efficacy of RYGB over SG in achieving weight loss. Methods Patients undergoing SG (n = 19) and RYGB (n = 40) were studied before surgery and at 2,12, 26, and 52 weeks postoperatively. Blood samples drawn in the fasted state and after a liquid mixed meal were assayed at baseline, 26, and 52 weeks for peptide YY (PYY), glucagon-like peptide-1 (GLP-1), ghrelin, insulin, glucose, and leptin. Fasting and postprandial appetitive sensations were assessed by visual analog scale. Results At 1 year there was greater weight loss in RYGB compared with SG patients (30% vs 27%; P = 0.03). Area under the curve (AUC) after the mixed meal for PYY was greater in RYGB patients (P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0236133