Original Article
International Journal of Obesity (2008) 32, 1640–1646; doi:10.1038/ijo.2008.157; published online 16 September 2008
Postprandial changes in gut regulatory peptides in gastric bypass patients
C Holdstock1, B Zethelius2, M Sundbom3, F A Karlsson1 and B Edén Engström1
- 1Departments of Medical Sciences/Internal Medicine, University Hospital, Uppsala, Sweden
- 2Department of Public Health and Caring Sciences/Geriatrics, Outpatient Clinic for Obesity Care, University Hospital, Uppsala, Sweden
- 3Department of Surgical Sciences, University Hospital, Uppsala, Sweden
Correspondence: Dr C Holdstock, Department of Medical Sciences, Uppsala University Hospital, Lab 16, Clinical Research Dept 2, Building 70, 3rd floor, Uppsala S-751 85, Sweden. E-mail: camilla.holdstock@medsci.uu.se
Received 14 February 2008; Revised 5 August 2008; Accepted 7 August 2008; Published online 16 September 2008.
Abstract
Objective:
The marked weight loss induced by Roux-en-Y gastric bypass (RYGBP) for morbid obesity is still incompletely understood. It has been suggested that, besides the restriction imposed by the surgical procedure, alterations in gut regulatory peptides signaling the brain might contribute. The aim of this study was to measure the putative satiety peptides peptide YY (PYY), glucagon-like peptide-1 (GLP-1), pancreatic polypeptide (PP) and pro-neurotensin (pro-NT) in response to fasting and feeding.
Design:
The study is a cross-sectional study. After a prolonged overnight 14 h fast, a standardized mixed meal (574 kcal) was provided. Blood samples for peptide measurements were obtained before and after the meal.
Subjects:
Forty subjects (20 males and females) were included; 10 morbidly obese; (mean age 41
7 years; mean BMI 443 kg/m2), 10 operated with RYGBP (age 455 years; BMI 356 kg/m2), 10 aged-matched lean (age 445 years; BMI 243 kg/m2) and 10 young lean subjects (age 262 years; BMI 232 kg/m2).
Measurements:
Plasma concentrations of PYY, GLP-1, PP and pro-NT were obtained.
Results:
PYY levels increased more in the RYGBP group than in the other groups after the test meal. GLP-1 levels rose in the RYGBP patients, with a small increase seen in the age-matched lean group. PP concentrations increased similarly in all groups postprandially. Pro-NT levels were highest in surgical patients, with no meal effect.
Conclusion:
RYGBP subjects displayed exaggerated PYY and GLP-1 responses to a standardized meal and demonstrated higher pro-NT levels both pre- and postprandially. The findings indicate that possibly the alterations in gut peptide secretion may promote weight loss after gastric bypass surgery.
Keywords:
gastric bypass surgery, postprandial, peptide YY, glucagon-like peptide-1, pancreatic polypeptide, pro-neurotensin
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