Abstract
Background
Changes in gastrointestinal and pancreatic hormones may play a role in promoting long-term
weight reduction and improved glucose metabolism after sleeve gastrectomy and Roux-en-Y
gastric bypass. However, few studies have examined the metabolic and endocrine effects
of these procedures in Mainland China.
Objectives
To compare the effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y
gastric bypass (LRYGB) on gastrointestinal and pancreatic peptide hormones.
Setting
University hospital, China.
Methods
A nonrandomized prospective study was conducted in Chinese obese patients undergoing
LSG or LRYGB. Of 20 patients in this study, 10 underwent LSG, and 10 underwent LRYGB.
Fasting plasma levels of insulin, glucagon, ghrelin, gastric inhibitory peptide, peptide
YY, glucagon-like peptide (GLP)-1, and GLP-2 were measured preoperatively and at 1,
3, 6, and 12 months after surgery. This trial was registered at www.clinicaltrials.gov (NCT02963662).
Results
During the first year after both operations, mean body mass index and fasting insulin
levels steadily decreased at all intervals. Fasting plasma glucose levels significantly
decreased at 1 month after surgery, then remained stable in both groups. Glucagon
levels significantly decreased at 1, 3, and 6 months after surgery in both groups,
but returned to baseline at 12 months. Fasting GLP-1 and peptide YY significantly
increased in both groups, but more so after LRYGB. However, GLP-2 did not change in
either group. Ghrelin levels significantly decreased after LSG, but not after LRYGB.
Gastric inhibitory peptide levels decreased after LRYGB but not after LSG.
Conclusions
LSG and LRYGB resulted in significant and distinct changes in multiple gastrointestinal
and pancreatic peptide hormones that are important regulators of obesity and metabolic
health.
Keywords
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Article info
Publication history
Published online: June 13, 2018
Accepted:
June 1,
2018
Received in revised form:
May 18,
2018
Received:
August 22,
2017
Footnotes
Supported by Science and Technology Planning Project of Guangdong Province, China, Grant Number: 2014 A020212219.
Jingge Yang and Zhiguang Gao contributed equally to this work.
Identification
Copyright
© 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
