title: Effect of Roux-en-Y gastric bypass vs sleeve gastrectomy on glucose and gut hormones: a prospective randomised trial.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most common bariatric technique. Laparoscopic sleeve gastrectomy (LSG) is a restrictive procedure; the metabolic and endocrine effects of which remain unknown. We compared the effects of both procedures on glucose metabolism and fasting and meal-stimulated gut hormone levels.
  
  
  METHODS
  Seven patients were randomised to LRYGB and eight to LSG. All patients were evaluated before and at 3 and 12 months postoperatively. Plasma levels of glucose, insulin, ghrelin, leptin, peptide YY (PYY), GLP-1 and pancreatic polypeptide were measured before and after 10 and 60 min of a standard test meal ingestion.
  
  
  RESULTS
  Age, body mass index and preoperative hormone levels were similar in both groups. A significant reduction of plasma glucose and insulin levels was observed after surgery. Moreover, a normalisation of homeostatic model assessment for insulin resistance value was also seen after both procedures. The fasting and postprandial leptin levels were significantly lower in the LRYGB group. LSG was followed by a significant reduction in fasting ghrelin levels. In the LRYGB group, GLP-1 levels increased significantly after the test meal.
  
  
  CONCLUSIONS
  LRYGB and LSG markedly improved glucose homeostasis. Only LSG decreased fasting and postprandial ghrelin levels, whereas GLP-1 and PYY levels increased similarly after both procedures.
authors.affiliation: Section of Gastrointestinal Surgery, Institut de Recerca Hospital del Mar (IMIM-Hospital del Mar), Hospital Universitari del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain. jramon@parcdesalutmar.cat
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Ramón
authors.forename: Silvia
authors.initials: S
authors.lastname: Salvans
authors.forename: Xenia
authors.initials: X
authors.lastname: Crous
authors.forename: Sonia
authors.initials: S
authors.lastname: Puig
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.forename: David
authors.initials: D
authors.lastname: Benaiges
authors.forename: Lourdes
authors.initials: L
authors.lastname: Trillo
authors.forename: Manuel
authors.initials: M
authors.lastname: Pera
authors.forename: Luis
authors.initials: L
authors.lastname: Grande
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass; D005768:Gastrointestinal Hormones / Q000097:blood*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D011863:Radioimmunoassay; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D005768:Gastrointestinal Hormones