title: Changes in gut hormone profile and glucose homeostasis after laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  Changes in glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) levels after bariatric surgery have been proposed as a mechanism for long-term maintenance of weight loss and improvement in glucose homeostasis postoperatively. The objective of the present study was to assess the changes in GLP-1, PYY, insulin, and glucose levels after laparoscopic sleeve gastrectomy (SG).
  
  
  METHODS
  Ten morbidly obese patients without type 2 diabetes (3 male, 7 female; body mass index [BMI] 47.92±2.06 kg/m(2)) were evaluated preoperatively and at 6 weeks, 6 months, and 12 months after SG. Total GLP-1, total PYY, insulin, and glucose were measured in fasting state and every 30 minutes after ingestion of 75 g glucose for a total time of 120 minutes.
  
  
  RESULTS
  BMI decreased markedly postoperatively (P<.001). Postprandial total GLP-1 and total PYY responses, measured by the area under the curve (AUC), were significantly increased by the sixth postoperative week compared with preoperative period (P<.001). Fasting insulin levels were markedly decreased postoperatively at all time points (all P<.01). Insulin AUC decreased progressively throughout the first postoperative year (P = .04), whereas glucose AUC decreased significantly at 6 and 12 months postoperatively (both P<.01). Insulin sensitivity measured by the Matsuda index increased progressively postoperatively. First phase insulin secretion remained unchanged.
  
  
  CONCLUSIONS
  Postprandial total GLP-1 and total PYY levels increased significantly at 6 weeks post-SG and remained elevated for at least 1 year. These findings may indicate their involvement in better glucose homeostasis and weight loss maintenance after SG.
authors.affiliation: Department of Endocrinology, University Hospital of Larissa, Larissa, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Papamargaritis
authors.forename: Carel W
authors.initials: CW
authors.lastname: le Roux
authors.forename: Eleni
authors.initials: E
authors.lastname: Sioka
authors.forename: George
authors.initials: G
authors.lastname: Koukoulis
authors.forename: George
authors.initials: G
authors.lastname: Tzovaras
authors.forename: Dimitris
authors.initials: D
authors.lastname: Zacharoulis
mesh_terms: D000328:Adult; D019540:Area Under Curve; D050110:Bariatric Surgery / Q000379:methods*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005768:Gastrointestinal Hormones / Q000378:metabolism*; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000378:metabolism; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D019894:Peptide YY / Q000378:metabolism; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D005768:Gastrointestinal Hormones; D007328:Insulin; D019894:Peptide YY; D052216:Glucagon-Like Peptide 1