Cazzo Everton, Pareja José Carlos, Chaim Elinton Adami, Coy Cláudio Saddy Rodrigues, Magro Daniéla Oliveira
Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n, Cidade Universitaria Zeferino Vaz, CEP, Campinas, SP, 13085-000, Brazil.
Obes Surg. 2018 Feb;28(2):506-512. doi: 10.1007/s11695-017-2875-3.
This paper aimed to evaluate the influence of modified biliopancreatic diversion (BPD) on the levels of GLP-1 and GLP-2 and correlate them with satiety regulation.
This is a pilot prospective cohort study that evaluated six mildly obese individuals with type 2 diabetes mellitus, which underwent modified BPD and were followed-up for 12 months. Levels of GLP-1 and GLP-2 after a standard meal tolerance test were determined and correlated with satiety scores obtained by means of a visual analogue scale (VAS).
There were significant changes in BMI (33 ± 2.2 versus 26.3 ± 2.2 kg/m; p < 0.001), HbA1c (7.9 ± 1.6 versus 5.8 ± 1.2%; p = 0.026), total cholesterol (172.3 ± 11.1 versus 134.7 ± 16.1 mg/dL; p < 0.001), LDL-c (103.3 ± 13 versus 64.6 ± 12.2 mg/dL; p < 0.001), and postprandial GLP-2 (972.7 ± 326.2 versus 1993.2 ± 1024.7; p = 0. 044). None of the scores obtained in the VAS significantly changed after surgery. After surgery, there were significant correlations of VAS scores and GLP-1 levels in question 01 ("how hungry do you feel?"; R = -0.928; p = .008) and GLP-2 levels in questions 02 ("how full do you feel?" R = 0.943; p = 0.005) and 04 ("how much do you think you can eat now? R = -0.829; p = 0.042).
Modified BPD does not lead to significant changes in satiety evaluated by the VAS; different aspects of satiety regulation are correlated with the postprandial levels of GLP-1 (hunger feeling) and GLP-2 (satiation feeling and desire to eat) 1 year after modified BPD, signaling a specific postoperative gut hormone-related modulation of appetite.
本文旨在评估改良胆胰转流术（BPD）对胰高血糖素样肽-1（GLP-1）和胰高血糖素样肽-2（GLP-2）水平的影响，并将其与饱腹感调节相关联。
这是一项前瞻性队列试点研究，评估了6例轻度肥胖的2型糖尿病患者，这些患者接受了改良BPD手术，并进行了12个月的随访。在标准餐耐量试验后测定GLP-1和GLP-2水平，并将其与通过视觉模拟量表（VAS）获得的饱腹感评分相关联。
体重指数（BMI）有显著变化（33±2.2对26.3±2.2kg/m²；p<0.001）、糖化血红蛋白（HbA1c）（7.9±1.6对5.8±1.2%；p=0.026）、总胆固醇（172.3±11.1对134.7±16.1mg/dL；p<0.001）、低密度脂蛋白胆固醇（LDL-c）（103.3±13对64.6±12.2mg/dL；p<0.001）以及餐后GLP-2（972.7±326.2对1993.2±1024.7；p=0.044）。VAS获得的评分在术后均无显著变化。术后，VAS评分与问题01中GLP-1水平（“你感觉有多饿？”；R=-0.928；p=0.008）以及问题02（“你感觉有多饱？”；R=0.943；p=0.005）和问题04（“你认为你现在能吃多少？”；R=-0.829；p=0.042）中GLP-2水平存在显著相关性。
改良BPD不会导致VAS评估的饱腹感出现显著变化；在改良BPD术后1年，饱腹感调节的不同方面与餐后GLP-1水平（饥饿感）和GLP-2水平（饱腹感和进食欲望）相关，这表明术后存在特定的与肠道激素相关的食欲调节。
