The effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study.

BACKGROUND

Rapid gastric emptying has been proposed to justify the increase in glucagon-like polypeptide-1 (GLP-1) after laparoscopic sleeve gastrectomy (LSG).

OBJECTIVES

To assess gastric emptying changes after LSG and their relationship with GLP-1 secretion.

SETTING

San Salvatore Hospital general surgery unit, University of L'Aquila, Italy.

METHODS

52 patients underwent gastric emptying scintigraphy for liquid and solid foods, before and 3 months after LSG. Twenty-six patients were in the liquid group (L group) and the remaining in the solid group (S group). We evaluated the half time of gastric emptying (T) and percentage of gastric retention (%GR) at 15, 30, and 60 minutes for liquids and at 30, 60, 90, and 120 minutes for solids. GLP-1 plasma concentrations were measured in each group before and after LSG and related to %GR. Statistical analysis was performed by Χ2 test and Pearson correlation(r).

RESULTS

After surgery, T was significantly accelerated: 15.2±13 min and 33.5±18 min in the L group and S group, respectively (P<.05). In both groups, GLP-1 plasma concentrations were increased at each blood sampling time: 2.91±2.9 pg/mL, 3.06±3.1 pg/mL and 3.21±2.6 pg/mL at 15, 30, and 60 minutes, respectively, (P<.05) for L group and 2.72±1.5 pg/mL, 2.89±2.1 pg/mL, 2.93±1.8 pg/mL, and 2.95±1.9 pg/mL at 30, 60, 90, and 120 minutes, respectively, (P< .05) for the S group. After LSG, GLP-1 and %GR presented a negative linear correlation (r) at each blood sampling time in both groups.

CONCLUSION

The rapid gastric emptying 3 months after LSG upregulates the production of GLP-1 in the distal bowel. Further studies are needed to confirm these findings.