title: Gastrin Secretion After Bariatric Surgery-Response to a Protein-Rich Mixed Meal Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy: a Pilot Study in Normoglycemic Women.
abstract: Recent investigations have linked elevated gastrin levels to the improvement of type 2 diabetes mellitus (T2DM). Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are effective treatments for T2DM, but it is not known if this is related to postoperative alterations of gastrin secretion.
  
  
  
  Twenty women previously operated with RYGB or SG and 13 female controls were enrolled and evaluated for body mass index, lipids, C-peptide, HbA1c, and anti-H. pylori IgG. Glucose, gastrin, insulin, and glucagon-like peptide 1 (GLP-1) concentrations were measured before and 30, 60, 90, and 120 min after ingestion of a protein-rich mixed meal.
  
  
  
  Six participants primarily selected were excluded due to usage of proton pump inhibitors, positive H.pylori IgG, or history of T2DM, yielding the following groups: RYGB (n = 9), SG (n = 8), and controls (n = 10). There were no differences in age, body mass index, HbA1c, or C-peptide levels between groups. RYGB had significantly lower area under the curve (AUC) for glucose during the test compared to controls (p = 0.013). RYGB showed lower serum gastrin levels compared to SG and controls (p < 0.05 for all). There was a non-significant increased gastrin release in SG compared to controls (p = 0.091). For SG and controls, there was a negative correlation between glucose and gastrin response (p = 0.0043).
  
  
  
  Gastrin secretion is diminished after RYGB. Hypergastrinemia was not present after SG, but a tendency of enhanced gastrin secretion was observed. These findings require further investigation in prospective studies.
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, N-7491, Trondheim, Norway. eivig@stud.ntnu.no.
authors.forename: Eivind
authors.initials: E
authors.lastname: Grong
authors.affiliation: Department of Surgery, Namsos Hospital, Nord Trøndelag Health Trust, Namsos, Norway.
authors.forename: Hallvard
authors.initials: H
authors.lastname: Græslie
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, N-7491, Trondheim, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Munkvold
authors.affiliation: Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Ingerid Brænne
authors.initials: IB
authors.lastname: Arbo
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, N-7491, Trondheim, Norway.|Centre for Obesity Research and Innovation, HMN (ObeCe), St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Bård Erik
authors.initials: BE
authors.lastname: Kulseng
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, N-7491, Trondheim, Norway.|Department of Gastroenterology and Hepatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Helge L
authors.initials: HL
authors.lastname: Waldum
authors.affiliation: Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), PB 8905, N-7491, Trondheim, Norway.|Centre for Obesity Research and Innovation, HMN (ObeCe), St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.|Department of Gastrointestinal Surgery and Norwegian National Advisory Unit on Advanced Laparoscopic Surgery (NSALK), St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Ronald
authors.initials: R
authors.lastname: Mårvik
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D004044:Dietary Proteins / Q000378:metabolism*; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D005755:Gastrins / Q000097:blood / Q000378:metabolism*; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism* / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D004044:Dietary Proteins; D005755:Gastrins; D007328:Insulin; D052216:Glucagon-Like Peptide 1
keywords: Gastrin; Glucagon-like peptide 1; Glycemic control; Glycosylated hemoglobin; Insulin; Mixed meal tolerance test; Roux-en-Y gastric bypass; Sleeve gastrectomy