Oliván Blanca, Teixeira Julio, Bose Mousumi, Bawa Baani, Chang Tangel, Summe Heather, Lee Hongchan, Laferrère Blandine
Obesity Research Center, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Ann Surg. 2009 Jun;249(6):948-53. doi: 10.1097/SLA.0b013e3181a6cdb0.
To examine the effect of an equivalent weight loss, by gastric bypass surgery (GBP) or by diet, on peptide YY3-36 (PYY3-36), ghrelin, and leptin levels and to determine the effect of diabetes status on PYY3-36 levels.
The increased PYY3-36 levels after GBP may be involved in the magnitude and the sustainability of weight loss after surgery.
Of the 30 morbidly obese women who participated in the study, 21 had type 2 diabetes mellitus, and were studied before and after equivalent weight loss of 10 kg by either GBP (n = 11) or by diet (n = 10).
: PYY3-36 levels were higher in obese diabetic as compared with nondiabetic individuals (64.1 +/- 34.4 pg/mL vs. 39.9 +/- 21.1 pg/mL; P < 0.05). PYY3-36 levels increased markedly in response to oral glucose after GBP (peak: 72.3 +/- 20.5 pg/mL-132.7 +/- 49.7 pg/mL; P < 0.001; AUC0-180: 51.5 +/- 23.3 pg/mL x min-91.1 +/- 32.2 pg/mL x min P < 0.001), but not after diet (peak: 85.5 +/- 51.9 pg/mL-84.8 +/- 41.13 pg/mL; P = NS; AUC0-180: 68.3 +/- 38.5 pg/mL x min-61.1 +/- 42.2 pg/mL.min P = NS). Fasting ghrelin levels increased after diet (425 +/- 91 pg/mL-519 +/- 105 pg/mL; P < 0.05), but did not change after GBP (506 +/- 121 pg/mL-482 +/- 196 pg/mL; P = NS).
Diabetes status seems to be a determinant of PYY3-36 levels. GBP, but not diet-induced weight loss, resulted in markedly increased glucose-stimulated PYY3-36 levels. The increase in stimulated PYY3-36 levels after GBP is likely a result of the surgery rather than a secondary outcome of weight loss. Changes in PYY3-36 levels and ghrelin could contribute to the success of GBP in sustaining weight loss.
通过胃旁路手术（GBP）或节食实现同等体重减轻，研究其对肽YY3-36（PYY3-36）、胃饥饿素和瘦素水平的影响，并确定糖尿病状态对PYY3-36水平的影响。
GBP术后PYY3-36水平升高可能与术后体重减轻的幅度和可持续性有关。
30名病态肥胖女性参与本研究，其中21名患有2型糖尿病，她们在通过GBP（n = 11）或节食（n = 10）实现10 kg同等体重减轻前后接受研究。
肥胖糖尿病患者的PYY3-36水平高于非糖尿病个体（64.1±34.4 pg/mL对39.9±21.1 pg/mL；P<0.05）。GBP术后口服葡萄糖后PYY3-36水平显著升高（峰值：72.3±20.5 pg/mL - 132.7±49.7 pg/mL；P<0.001；AUC0-180：51.5±23.3 pg/mL·min - 91.1±32.2 pg/mL·min，P<0.001），但节食后未升高（峰值：85.5±51.9 pg/mL - 84.8±41.13 pg/mL；P =无显著性差异；AUC0-180：68.3±38.5 pg/mL·min - 61.1±42.2 pg/mL·min，P =无显著性差异）。节食后空腹胃饥饿素水平升高（425±91 pg/mL - 519±105 pg/mL；P<0.05），但GBP术后未改变（506±121 pg/mL - 482±196 pg/mL；P =无显著性差异）。
糖尿病状态似乎是PYY-36水平的一个决定因素。GBP而非节食引起的体重减轻导致葡萄糖刺激的PYY3-36水平显著升高。GBP术后刺激的PYY3-36水平升高可能是手术的结果，而非体重减轻的继发结果。PYY3-36水平和胃饥饿素的变化可能有助于GBP在维持体重减轻方面取得成功。
