Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
The Danish Diabetes Academy, Odense, Denmark.
J Clin Endocrinol Metab. 2020 Apr 1;105(4). doi: 10.1210/clinem/dgaa061.
Alterations in several gastrointestinal hormones are implicated in the postoperative suppression of food intake leading to weight loss after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). The aim was to evaluate changes in responses of gastrointestinal hormones after RYGB and SG and the associations of these changes with weight loss, energy intake, and food preferences.
Forty-two subjects with severe obesity were included (32 RYGB; 10 SG). Postprandial responses of glicentin, oxyntomodulin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and ghrelin were measured before and 6 months after surgery. Energy intake and energy density were assessed before and 6 months after surgery using a buffet meal test and weight loss was assessed 18 months after surgery.
Postprandial concentrations of glicentin, oxyntomodulin, GLP-1, and ghrelin differed between RYGB and SG (all P ≤ .02). Enhanced responses of glicentin and oxyntomodulin predicted a greater weight loss (both P < .01) and were associated with a larger decrease in energy density (P ≤ .04). No associations were found for GLP-1, PYY, and ghrelin, and changes were not associated with changes in energy intake. When combing all hormones, 60%, 19%, and 33% of the variations in weight loss, energy intake, and energy density, respectively, could be explained.
Postprandial responses of gastrointestinal hormones differed between RYGB and SG. Enhanced responses of glicentin and oxyntomodulin predicted a better weight loss and were associated with a decreased preference for energy-dense foods. Replication of these results could imply an opportunity to identify patients in need of additional support after surgical treatments of obesity.
几种胃肠道激素的改变与 Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）后食物摄入减少导致体重减轻有关。目的是评估 RYGB 和 SG 后胃肠激素反应的变化，以及这些变化与体重减轻、能量摄入和食物偏好的关系。
纳入 42 例严重肥胖患者（RYGB 32 例，SG 10 例）。术前和术后 6 个月测量餐后胃泌素释放肽（glicentin）、胆囊收缩素（oxyntomodulin）、胰高血糖素样肽-1（GLP-1）、肽 YY（PYY）和 ghrelin 的反应。术前和术后 6 个月采用自助餐测试评估能量摄入和能量密度，术后 18 个月评估体重减轻情况。
RYGB 和 SG 之间餐后 glicentin、oxyntomodulin、GLP-1 和 ghrelin 的浓度不同（均 P ≤.02）。glicentin 和 oxyntomodulin 反应增强预测体重减轻更大（均 P <.01），与能量密度降低更大相关（P ≤.04）。GLP-1、PYY 和 ghrelin 无相关性，且变化与能量摄入变化无关。当结合所有激素时，体重减轻、能量摄入和能量密度的变化分别有 60%、19%和 33%可以解释。
RYGB 和 SG 之间餐后胃肠激素反应不同。glicentin 和 oxyntomodulin 反应增强预测体重减轻更好，并与对能量密集型食物的偏好降低相关。这些结果的复制可能意味着有机会识别肥胖症手术后需要额外支持的患者。
