title: Recombinant human leptin does not alter gut hormone levels after gastric bypass but may attenuate sweet cravings.
abstract: Bariatric surgery improves glucose homeostasis and alters gut hormones partly independent of weight loss. Leptin plays a role in these processes; levels are decreased following bariatric surgery, creating a relative leptin insufficiency. We previously showed that leptin administration in a weight-reduced state after Roux-en-Y gastric bypass (RYGB) caused no further weight loss. Here, we discuss the impact of leptin administration on gut hormones, glucostasis, and appetite. Weight stable women after RYGB were randomized to receive placebo or recombinant human metreleptin (0.05 mg/kg twice daily). At weeks 0 and 16, a liquid meal challenge was performed. Glucose, insulin, C-peptide, GLP-1, PYY, glucagon, and ghrelin (total, acyl, and desacyl) were measured fasting and postprandially. Appetite was assessed using a visual analog scale. Mean post-op period was 53 ± 2.3 months; mean BMI was 34.6 ± 0.2 kg/m(2). At 16 weeks, there was no significant change in weight within or between groups. Fasting PYY was significantly different between groups and the leptin group had lower sweets craving at week 16 than the placebo group (P < 0.05). No other differences were observed. Leptin replacement does not alter gut hormones or glucostasis but may diminish sweet cravings compared to placebo in this population of post-RYGB women.
authors.affiliation: Division of Pediatric Endocrinology, Columbia University Medical Center, New York, NY 10032, USA ; Division of Pediatric Endocrinology, Baystate Medical Center, Springfield, MA 01199, USA.
authors.forename: Rushika
authors.initials: R
authors.lastname: Conroy
authors.affiliation: Division of Endocrinology, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Gerardo
authors.identifier: 0000-0001-6650-7048
authors.initials: G
authors.lastname: Febres
authors.affiliation: Division of Endocrinology, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: McMahon
authors.affiliation: Division of Medicine, University of Virginia Medical Center, Charlottesville, VA 22902, USA.
authors.forename: Michael O
authors.initials: MO
authors.lastname: Thorner
authors.affiliation: Division of Medicine, University of Virginia Medical Center, Charlottesville, VA 22902, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Gaylinn
authors.affiliation: Division of Endocrinology, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Irene
authors.identifier: 0000-0003-2628-9407
authors.initials: I
authors.lastname: Conwell
authors.affiliation: Division of Medicine, Cornell University Medical Center, New York, NY 10021, USA.
authors.forename: Louis
authors.initials: L
authors.lastname: Aronne
authors.affiliation: Division of Endocrinology, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Korner