Endocrine and metabolic response to gastric bypass.
OBJECTIVE
Diabetes resolves in 80% of individuals undergoing successful Roux-en-Y gastric bypass. Absolute caloric restriction alone resulting from gastric anatomic changes indeed leads to weight loss; however, immediate effects in glycemic control often precede substantial weight loss typically associated with insulin sensitivity. One putative explanation relates to hormonal effects accompanying Roux-en-Y gastric bypass. We reviewed the existing and recent literature to investigate the hormonal changes accompanying Roux-en-Y gastric bypass.


RESULTS
Changes in levels of five candidate enteric hormones have been recently associated with early postoperative glycemic control following Roux-en-Y gastric bypass; the strongest effects are seen with variations in glucagon-like peptide-1, glucose-dependent insulinotropic peptide and ghrelin.


CONCLUSIONS
The unique hybridization of static anatomic restriction and dynamic absorptive bypass lends a duality to the beneficial effects of Roux-en-Y gastric bypass. This duality likely explains the short-term and long-term resolution of diabetes in patients undergoing Roux-en-Y gastric bypass.
Saliba
Jabbar
J
Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Wattacheril
Julia
J
Abumrad
Naji N
NN
D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism; D002149:Energy Intake / Q000502:physiology; D015390:Gastric Bypass; D005749:Gastric Inhibitory Polypeptide / Q000378:metabolism; D054439:Ghrelin / Q000378:metabolism; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D006801:Humans; D054795:Incretins / Q000378:metabolism; D009767:Obesity, Morbid / Q000378:metabolism* / Q000601:surgery*; D036361:Peptide Hormones / Q000378:metabolism*; D015431:Weight Loss / Q000502:physiology*
D054439:Ghrelin; D054795:Incretins; D036361:Peptide Hormones; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1