The effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study.
BACKGROUND
Rapid gastric emptying has been proposed to justify the increase in glucagon-like polypeptide-1 (GLP-1) after laparoscopic sleeve gastrectomy (LSG).


OBJECTIVE
To assess gastric emptying changes after LSG and their relationship with GLP-1 secretion.


METHODS
San Salvatore Hospital general surgery unit, University of L'Aquila, Italy.


METHODS
52 patients underwent gastric emptying scintigraphy for liquid and solid foods, before and 3 months after LSG. Twenty-six patients were in the liquid group (L group) and the remaining in the solid group (S group). We evaluated the half time of gastric emptying (T1/2) and percentage of gastric retention (%GR) at 15, 30, and 60 minutes for liquids and at 30, 60, 90, and 120 minutes for solids. GLP-1 plasma concentrations were measured in each group before and after LSG and related to %GR. Statistical analysis was performed by Χ2 test and Pearson correlation(r).


RESULTS
After surgery, T1/2was significantly accelerated: 15.2±13 min and 33.5±18 min in the L group and S group, respectively (P<.05). In both groups, GLP-1 plasma concentrations were increased at each blood sampling time: 2.91±2.9 pg/mL, 3.06±3.1 pg/mL and 3.21±2.6 pg/mL at 15, 30, and 60 minutes, respectively, (P<.05) for L group and 2.72±1.5 pg/mL, 2.89±2.1 pg/mL, 2.93±1.8 pg/mL, and 2.95±1.9 pg/mL at 30, 60, 90, and 120 minutes, respectively, (P< .05) for the S group. After LSG, GLP-1 and %GR presented a negative linear correlation (r) at each blood sampling time in both groups.


CONCLUSIONS
The rapid gastric emptying 3 months after LSG upregulates the production of GLP-1 in the distal bowel. Further studies are needed to confirm these findings.
Dipartimento di Scienze Cliniche Applicate e Biotecnologie (DISCAB), Ospedale civile San Salvatore, University of L'Aquila, L'Aquila, Italy. Electronic address: silversista@gmail.com.
Federico
F
Sista
Dipartimento di Scienze Cliniche Applicate e Biotecnologie (DISCAB), Ospedale civile San Salvatore, University of L'Aquila, L'Aquila, Italy.
Valentina
V
Abruzzese
Dipartimento di Scienze Cliniche Applicate e Biotecnologie (DISCAB), Ospedale civile San Salvatore, University of L'Aquila, L'Aquila, Italy.
Marco
M
Clementi
Service de Chirurgie Digestive, Hôpital Avicenne , Université Paris XIII, Bobigny, France.
Sergio
S
Carandina
Dipartimento di Scienze Cliniche Applicate e Biotecnologie (DISCAB), Ospedale civile San Salvatore, University of L'Aquila, L'Aquila, Italy.
Manuela
M
Cecilia
Dipartimento di Scienze Cliniche Applicate e Biotecnologie (DISCAB), Ospedale civile San Salvatore, University of L'Aquila, L'Aquila, Italy.
Gianfranco
G
Amicucci
D000328:Adult; D000704:Analysis of Variance; D050110:Bariatric Surgery / Q000379:methods; D005260:Female; D005743:Gastrectomy; D005746:Gastric Emptying / Q000502:physiology; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000150:complications; D007037:Hypothyroidism / Q000150:complications; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D012891:Sleep Apnea Syndromes / Q000150:complications; D015854:Up-Regulation
D052216:Glucagon-Like Peptide 1
Bariatric surgery; GLP-1 secretion; Gastric emptying; Laparoscopic sleeve gastrectomy; Obesity