Different Effect of Laparoscopic Roux-en-Y Gastric Bypass and Open Biliopancreatic Diversion of Scopinaro on Serum PYY and Ghrelin Levels

Abstract

BPD results in a greater increase in PYY and a lower weight loss than RYGB. However, only RYGB was associated with a significant increase in ghrelin. The differing weight loss according to the type of bariatric surgery does not seem to be explained by changes arising in PYY and ghrelin.

Ghrelin in obesity and endocrine diseases

“…Increases in ghrelin levels post-gastric bypass have also been seen (Garcia-Fuentes et al, 2008;Holdstock et al, 2003;Perez-Romero et al, 2010;Ybarra et al, 2009); however this may be associated with active weight loss rather than the surgery itself (Faraj et al, 2003). Several explanations have been proposed for the conflicting findings regarding ghrelin levels following gastric bypass surgery including differences in pre-operative insulin resistance, surgical methods and post-operative vagal nerve dysfunction (Pournaras & le Roux, 2010;Vincent & le Roux, 2008).…”

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

“…Nonetheless even at equivalent levels of weight loss, fasting ghrelin levels are highly variable. Early studies of RYGB demonstrate this adroitly; some demonstrate an increase in fasting ghrelin levels compared with presurgical level in the context of significant weight loss (61,76,206); others show lower or unchanged fasting ghrelin levels in the context of similar weight loss (39, 51, 54, 57-59, 63, 84, 92, 95, 110, 114, 115, 117, 118, 131, 145, 164, 185, 198, 215), and therefore should be viewed as absolute or relative falls in ghrelin secretion, respectively (in general these studies commenced ghrelin measurements beyond 6 mo after surgery and thus fail to show an initial fall in fasting ghrelin). This heterogeneity could result from variations in compensatory ghrelin hypersecretion and magnitude of weight loss, in combination with the antagonistic effect of surgery.…”

Bariatric surgery and bone disease: from clinical perspective to molecular insights

“…96 Low bone mass was observed in PYY gene knockout models. 100 PYY levels increase after RNYGB and biliopancreatic diversion, 101 adjustable gastric band, 102 and sleeve gastrectomy. 103 To our knowledge, no clinical study to date has correlated PYY levels with bone density in bariatric surgery patients.…”