title: Gastric bypass surgery restores meal stimulation of the anorexigenic gut hormones glucagon-like peptide-1 and peptide YY independently of caloric restriction.
abstract: BACKGROUND
  The effects of gastric bypass surgery on the secretion of the anorexigenic gut-derived hormones glucagon-like peptide-1 (GLP-1) and peptide YY (PYY), independent of caloric restriction and due to different dietary macronutrients, is not well characterized. This study examines the effects of a mixed-nutrient or high-fat liquid meal on the postprandial stimulation of GLP-1 and PYY following gastric bypass or equivalent hypocaloric diet.
  
  
  METHODS
  Total PYY and active GLP-1 were measured fasting and at multiple points after standardized mixed-nutrient and high-fat liquid meals in two matched groups of obese subjects. The meal stimulation tests were performed before and 14.6 ± 3.3 days after gastric bypass (GBP, n = 10) and before and after a 7-day hypocaloric liquid diet matching the post-GBP diet (control, n = 10).
  
  
  RESULTS
  Mixed-nutrient and high-fat postprandial GLP-1 levels increased following GBP (mixed-nutrient peak: 85.0 ± 28.6-323 ± 51 pg/ml, P < 0.01; high-fat peak: 81.8 ± 9.6-278 ± 49 pg/ml, P < 0.01), but not after diet (mixed-nutrient peak: 104.4 ± 9.4-114.9 ± 15.8 pg/ml, P = NS; high-fat peak: 118.1 ± 16.4-104.4 ± 10.8 pg/ml, P = NS). The postprandial PYY response also increased after GBP but not diet, though the increase in peak PYY did not reach statistical significance (GBP mixed-nutrient peak: 134.8 ± 26.0-220.7 ± 52.9 pg/ml, P = 0.09; GBP high-fat peak: 142.1 ± 34.6-197.9 ± 12.7 pg/ml, P = 0.07; diet mixed-nutrient peak: 99.8 ± 8.0-101.1 ± 13.3 pg/ml, P = NS; diet high-fat peak: 105.0 ± 8.8-103.1 ± 11.8 pg/ml, P = NS). The postprandial GLP-1 response was not affected by the macronutrient content of the meal. However, following GBP the mixed-nutrient PYY total area under the curve (AUC(0-120)) was significantly greater than the high-fat PYY AUC(0-120) (22,081 ± 5,662 pg/ml min vs. 18,711 ± 1,811 pg/ml min, P = 0.04).
  
  
  CONCLUSIONS
  Following GBP there is an increase in the postprandial stimulation of PYY and GLP-1 that is independent of caloric restriction. The phenomenon of "bariatric surgery-induced anorexia" may be linked to the increased levels after GBP.
authors: Department of Surgery, DUMC 3351, Duke University Medical Center, Durham, NC 27713, USA.
authors: Sarah
authors: S
authors: Evans
authors: Zehra
authors: Z
authors: Pamuklar
authors: Jonathan
authors: J
authors: Rosko
authors: Patrick
authors: P
authors: Mahaney
authors: Ning
authors: N
authors: Jiang
authors: Chan
authors: C
authors: Park
authors: Alfonso
authors: A
authors: Torquati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001066:Appetite; D015992:Body Mass Index; D031204:Caloric Restriction; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D059305:Diet, High-Fat; D005215:Fasting / Q000502:physiology; D005260:Female; D005502:Food; D015390:Gastric Bypass; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery; D019894:Peptide YY / Q000378:metabolism*; D019518:Postprandial Period / Q000502:physiology; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
chemical_list: D019894:Peptide YY; D052216:Glucagon-Like Peptide 1