PMID- 31338735
OWN - NLM
STAT- MEDLINE
DCOM- 20200520
LR  - 20210110
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 29
IP  - 12
DP  - 2019 Dec
TI  - Non-responders After Gastric Bypass Surgery for Morbid Obesity: Peptide Hormones 
      and Glucose Homeostasis.
PG  - 4008-4017
LID - 10.1007/s11695-019-04089-8 [doi]
AB  - INTRODUCTION: About 20% of patients operated with Roux-en-Y gastric bypass 
      (RYGBP) experience poor long-term weight result. This study compared levels of 
      leptin and gut hormones in long-term weight responders with non-responders after 
      RYGBP. In a subgroup analysis, hormone levels were assessed in T2DM (type 2 
      diabetes mellitus) and normoglycemic participants. METHODS: Insulin, glucose, 
      leptin, acyl-ghrelin, total PYY, active GLP-1, and GIP were measured during an 
      oral glucose tolerance test (OGTT) in post-RYGBP subjects: 22 non-responders (BMI 
      40.6 +/- 6.0 kg/m(2) after an excess BMI loss [EBMIL] of 26.0 +/- 15.9%) and 18 
      responders (BMI 29.5 +/- 3.5 kg/m(2) after an EBMIL of 74.9 +/- 18.2%). Subjects were 
      matched for preoperative age, BMI, and years of follow-up. Measures of glucose 
      homeostasis were calculated, and body composition was measured. RESULTS: Fat 
      mass-adjusted fasting leptin correlated negatively with %EBMIL (r = - 0.57, 
      p < 0.01). Non-responders presented higher levels of leptin during the OGTT. 
      Leptin decreased and ghrelin returned to baseline levels earlier in 
      non-responders. Despite having higher insulin resistance than responders, 
      non-responders demonstrated similar OGTT responses of GLP-1, GIP, and PYY. T2DM 
      participants demonstrated lower GLP-1 levels than normoglycemic participants of 
      similar weight. CONCLUSION: Fasting leptin is associated with weight result after 
      RYGBP, and hormonal responses to a glucose oral load might work towards promoting 
      obesity in long-term non-responders after RYGBP. Poor long-term weight result and 
      glycemic status after RYGBP are each associated with differences in peptide 
      hormone levels.
FAU - Sima, Eduardo
AU  - Sima E
AUID- ORCID: 0000-0001-7373-4767
AD  - Department of Surgical Sciences, Upper Abdominal Surgery, University Hospital, 
      Uppsala University, SE-75185, Uppsala, Sweden. eduardo.sima@surgsci.uu.se.
FAU - Webb, Dominic-Luc
AU  - Webb DL
AD  - Department of Medical Sciences, Gastroenterology and Hepatology Unit, Uppsala 
      University, Uppsala, Sweden.
FAU - Hellstrom, Per M
AU  - Hellstrom PM
AD  - Department of Medical Sciences, Gastroenterology and Hepatology Unit, Uppsala 
      University, Uppsala, Sweden.
FAU - Sundbom, Magnus
AU  - Sundbom M
AD  - Department of Surgical Sciences, Upper Abdominal Surgery, University Hospital, 
      Uppsala University, SE-75185, Uppsala, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Gastrointestinal Hormones)
RN  - 0 (Insulin)
RN  - 0 (Peptide Hormones)
SB  - IM
MH  - Adult
MH  - Biomarkers/blood
MH  - Blood Glucose/*metabolism
MH  - Body Mass Index
MH  - Case-Control Studies
MH  - Diabetes Mellitus, Type 2/blood
MH  - Female
MH  - Follow-Up Studies
MH  - *Gastric Bypass
MH  - Gastrointestinal Hormones/*blood
MH  - Glucose Tolerance Test
MH  - Homeostasis
MH  - Humans
MH  - Insulin/blood
MH  - Insulin Resistance
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/blood/*surgery
MH  - Peptide Hormones/*blood
MH  - Treatment Failure
MH  - Weight Loss
OTO - NOTNLM
OT  - Gastric bypass
OT  - Incretins
OT  - Leptin
OT  - Long-term results
OT  - Weight loss
EDAT- 2019/07/25 06:00
MHDA- 2020/05/21 06:00
CRDT- 2019/07/25 06:00
PHST- 2019/07/25 06:00 [pubmed]
PHST- 2020/05/21 06:00 [medline]
PHST- 2019/07/25 06:00 [entrez]
AID - 10.1007/s11695-019-04089-8 [pii]
AID - 10.1007/s11695-019-04089-8 [doi]
PST - ppublish
SO  - Obes Surg. 2019 Dec;29(12):4008-4017. doi: 10.1007/s11695-019-04089-8.