Glucagon-Like Peptide-1, Peptide YY, Hunger, and Satiety after Gastric Bypass Surgery in Morbidly Obese Subjects

• Published in: The journal of clinical endocrinology and metabolism Vol. 91; no. 5; pp. 1735 - 1740
• Main Authors: Morínigo, Rosa, Moizé, Violeta, Musri, Melina, Lacy, Antonio M., Navarro, Salvador, Marín, José Luís, Delgado, Salvadora, Casamitjana, Roser, Vidal, Josep
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.05.2006; Copyright by The Endocrine Society
• Subjects: Adult; Appetite loss; Body mass index; Body weight loss; Eating - physiology; Eating - psychology; Female; Gastric bypass; Gastric Bypass - psychology; Gastric Emptying - physiology; Gastrointestinal surgery; Gastrointestinal Transit - physiology; Glucagon; Glucagon-like peptide 1; Glucagon-Like Peptide 1 - blood; Humans; Hunger; Hunger - physiology; Male; Obesity, Morbid - surgery; Peptide YY - blood; Peptides; Prospective Studies; Satiety; Satiety Response - physiology; Surgery
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2005-0904

Context: The mechanisms underlying weight loss after Roux-en-Y gastric bypass (RYGBP) are not well understood. Objective: The objective of the study was to assess the changes in active glucagon-like peptide 1 (GLP-1) and total peptide YY (PYY) after RYGBP and examine their relationship with changes in hunger and satiety. Design: This was a prospective study on the changes in active GLP-1, PYY, hunger, and satiety in response to a standardized test meal in nine normal-glucose-tolerant obese subjects [body mass index (BMI) 47.4 ± 6.1 kg/m2] before and 6 wk after RYGBP. Results: Before surgery, meal ingestion failed to stimulate GLP-1 and PYY secretion. Six weeks after surgery, despite subjects still being markedly obese (BMI 43.6 ± 7.8 kg/m2), the area under the curve0–120′ of GLP-1 and of PYY in response to the standardized test meal were significantly elevated (P < 0.05 and P < 0.01, respectively). These hormonal responses were significantly larger (P < 0.01) than those observed in a group matched for the BMI attained 6 wk after surgery. The 2.9 ± 1.2- and 1.6 ± 1.9-fold increase, respectively, in the area under the curve0–120′ of GLP-1 and PYY were accompanied by a significant decrease in fasting (P < 0.05) and postprandial hunger (P = 0.05) and a significant increase in satiety (P < 0.05) after meal intake. Nevertheless, a significant correlation between changes in the hormonal and eating behavior parameters was not found. Conclusion: Our data show that RYGBP is associated with an improvement in the active GLP-1 and total PYY response to a liquid-meal intake. Moreover, we provide circumstantial evidence for a potential role of these gastrointestinal hormones on the decreased appetite after RYGBP.