title: Changes in levels of selected incretins and appetite-controlling hormones following surgical treatment for morbid obesity.
abstract: BACKGROUND
  The hormonal brain-gut axis is a crucial element in appetite control and the response to surgical treatment for super obesity. However, mechanisms underlying the metabolic response to surgical treatment for morbid obesity are still not clearly specified.
  
  
  OBJECTIVE
  To evaluate and compare the effects of surgical treatment for super obesity by laparoscopic sleeve gastrectomy (LSG) and by laparoscopic Roux-en-Y gastric bypass (LRYGB) on selected incretins and appetite-controlling hormones.
  
  
  METHODS
  Thirty-five patients were enrolled in a prospective study. Laparoscopic sleeve gastrectomy was performed in 45.8% of patients, and LRYGB in the remaining 54.2% of patients. Before the procedure fasting blood serum was collected from patients and preserved, to determine levels of selected incretins and brain-gut hormones: glucagon-like peptide 1 (GLP-1), peptide YY (PYY), leptin, and ghrelin.
  
  
  RESULTS
  Twenty-eight patients came to a follow-up visit 12 months after the surgery. In these patients selected parameters were determined again. The percentage weight loss was 58.8%. The ghrelin levels had decreased, and no statistically significant difference was observed between the two procedures. After both surgical procedures a statistically significant reduction in the leptin level was also observed. Peptide YY levels statistically significantly increased in the whole studied group. The GLP-1 level increased after the surgical procedure. However, the observed change was not statistically significant.
  
  
  CONCLUSIONS
  Both treatment methods result in modification of secretion patterns for selected gastrointestinal hormones, and this was considered to be a beneficial effect of bariatric treatment. The laparoscopic sleeve gastrectomy, being a procedure resulting in a metabolic response, seems to be an equally effective method for treatment of super obesity and comorbidities as the laparoscopic gastric bypass.
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Major
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Matłok
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Pędziwiatr
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Migaczewski
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Zub-Pokrowiecka
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Radkowiak
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Winiarski
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Zychowicz
authors.affiliation: Department of Clinical Biochemistry, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Fedak
authors.affiliation: 2 Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Budzyński
keywords: Roux-en-Y gastric bypass (RYGB); bariatric surgery; ghrelin; glucagon-like peptide 1; laparoscopic sleeve gastrectomy (LSG); leptin