Gastrointestinal hormones and gastric emptying 20 years after jejunoileal bypass for massive obesity.
OBJECTIVE
Some studies have shown a more rapid gastric emptying in obese subjects. Six to twelve months after jejunoileal bypass (JIB) neurotensin (NT) and enteroglucagon have been shown to be elevated after food intake. These hormones, together with peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) have been implicated in the reduction of upper gastrointestinal motility seen after infusion of nutrients into the ileum.


OBJECTIVE
To study if the postprandial gut hormone pattern and gastric emptying is altered 20 y after JIB.


METHODS
Seven subjects operated with JIB a mean (s.d.) 20 +/- 3 y ago, with a BMI of 44 +/- 4 kg/m2 at the time of surgery and 31 +/- 4 at present. For comparison seven sex-matched non-operated obese controls (BMI 43 +/- 3) were studied.


METHODS
Serial blood samples were obtained every 10 min after intake of a 280 kcal meal. Radioimmunoassays for motilin, cholecystokinin (CCK), NT, PYY and GLP-1 were performed. Gastric emptying of a solid meal was studied using a radioactively labelled omelette (of 310 kcal) for 120 min).


RESULTS
After JIB postprandial motilin, CCK, NT, PYY and GLP-1 were elevated compared to non-operated obese subjects. Similarly, basal levels of CCK, motilin, GLP-1 and PYY were elevated in the operated group. No difference was observed in the rate of gastric emptying between the two groups.


CONCLUSIONS
Both fasting and postprandial gut hormone levels are elevated 20 y after JIB. The impact of long-term rapid stimulation of the ileum and subsequent raised gut hormone levels on gastric emptying is not clear.
Näslund
E
E
Department of Surgery, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden.
Grybäck
P
P
Hellström
P M
PM
Jacobsson
H
H
Holst
J J
JJ
Theodorsson
E
E
Backman
L
L
D002766:Cholecystokinin / Q000097:blood / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology*; D005768:Gastrointestinal Hormones / Q000097:blood* / Q000378:metabolism; D052216:Glucagon-Like Peptide 1; D006801:Humans; D007581:Jejunoileal Bypass; D008297:Male; D008875:Middle Aged; D009037:Motilin / Q000097:blood / Q000378:metabolism; D009496:Neurotensin / Q000097:blood / Q000378:metabolism; D009767:Obesity, Morbid / Q000601:surgery*; D019894:Peptide YY; D010455:Peptides / Q000097:blood / Q000378:metabolism; D019518:Postprandial Period; D013997:Time Factors
D005768:Gastrointestinal Hormones; D010455:Peptides; D019894:Peptide YY; D009496:Neurotensin; D009037:Motilin; D052216:Glucagon-Like Peptide 1; D002766:Cholecystokinin