Gut and Pancreatic Hormones after Jejunoileal Bypass with 3:1 or 1:3 Jejunoileal Ratio

Sørensen, Thorkild I A; Lauritsen, K. B.; Jj, Holst; Stadil, F.; Andersen, Bjørn

doi:10.1159/000198880

Cited by 23 publications

(16 citation statements)

References 17 publications

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“…Following obesity surgery, there is no evidence of an increased release (Table 2) ( [77,78] and Le Roux CW, Aylwin SJB, Bloom SR, unpublished data).…”

Section: Effect Of Bariatric Surgery On Gi Hormones That Inhibit Appementioning

confidence: 99%

Gastrointestinal surgery and gut hormones

Aylwin¹

2005

Current Opinion in Endocrinology & Diabetes

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Purpose of review Surgical treatment of obesity remains by far the most effective means of achieving weight loss, and in addition leads to normalised glucose tolerance in patients with type 2 diabetes mellitus (T2DM). Bariatric surgical procedures have recently been shown to effect changes in the secretion of gastro-intestinal hormones involved in energy regulation and intermediary metabolism that may contribute to appetite reduction, weight loss and remission of T2DM. Recent findingsGhrelin is released from the stomach in the pre-prandial state and stimulates food intake. Weight loss through dietary restraint elevates the low circulating levels of ghrelin in obese subjects, but following Roux-en-Y gastric bypass surgery (RYGB), obese subjects were shown to have suppressed levels of ghrelin. Subsequent prospective studies, however, have found inconsistent ghrelin responses following RYGB. Peptide YY (PYY) is expressed in the ileum, released in response to the ingestion of food and acts centrally to inhibit food intake. Recent studies have shown that PYY levels are reduced in obesity although obese subjects remain sensitive to exogenous PYY. Following RYGB, PYY release is exaggerated, an effect that should inhibit subsequent meal size. Glucagon-like peptide 1 (GLP-1), released from the same cells as PYY, shows a pronounced post-prandial elevation after RYGB that may be responsible for an enhanced early insulin release and contribute to the normalisation of glucose homeostasis. SummaryThe pleiotropic endocrine effects of RYGB that favor weight loss present strong circumstantial evidence for a humoral effect of RYGB on appetite and food intake. Mimicking the effects of RYGB on the entero-hypothalamic axis has become an attractive goal for pharmacotherapy.

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“…Following obesity surgery, there is no evidence of an increased release (Table 2) ( [77,78] and Le Roux CW, Aylwin SJB, Bloom SR, unpublished data).…”

Section: Effect Of Bariatric Surgery On Gi Hormones That Inhibit Appementioning

confidence: 99%

Gastrointestinal surgery and gut hormones

Aylwin¹

2005

Current Opinion in Endocrinology & Diabetes

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“…We do not agree that subtraction of the C-terminal ('pancreatic') immunoreactivity from N-terminal-to-central ('total') immuno reactivity [3,37] gives an accurate measure ment of gut glucagon precursors since some material larger than glucagon, which binds only the latter type (N-terminal-to-central) of antibody, is found in the pancreas and is released into the circulation following argi nine stimulation [11,26]. Also, material which binds C-terminal antibodies may be released from the lower gut or formed follow ing the release of larger gut precursors by pro teolytic catabolism [25,26,30].…”

Section: Discussionmentioning

confidence: 71%

“…This contrast, together with the tendency for the non-func tional ileum to contain slightly more rather than less YY57 immunoreactivity, is not in dicative of a major hypertrophic or other role [3,7,16,35,37] for large glucagon precur sors) in the morphological changes which follow the operations. Dawson et al [7] re ported that the ileal enteroglucagon immuno reactivity was unchanged in the functional ileum of patients who had extensive JIB operations.…”

Section: Discussionmentioning

confidence: 82%

Glucagon, Secretin and Vasoactive Intestinal Polypeptide Immunoreactivities in Rat Gut after Jejuno-Ileal Bypass and Resection

Murphy¹,

Chen²,

Herlin³

et al. 1985

Digestion

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Jejuno-ileal bypass (JIB) and resection are associated with hyperplasic and other changes in residual functional gut. In studies on endocrine changes, circulating hormone levels are usually measured. In this study with Sprague-Dawley rats, glucagon, secretin and vasoactive intestinal polypeptide (VIP), immunoreactivities were measured in extracts of gut tissues including formerly adjacent segments of functional and bypassed jejunum and ileum. Young adult (200–220 g) and mature (404–440 g) rats received > 90% JIB. Though slight differences were observed in the response of the young and old rats to the operations, and between the effects of JIB and resection, the results do not indicate major involvement of secretin, VIP or gut glucagon-like immunoreactivity in the effects of surgery. Changes include increased immunoreactivity of secretin in the upper and of VIP in the lower functional gut following JIB. N-terminal-to central glucagon immunoreactivity in the functional ileum did not change substantially after operations, but was significantly lower in the non-functional than functional ileum after bypass. Plasma levels of this immunoreactivity were higher following operations and highest following resection.

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“…Intestinal resection provokes the hypersecretion of gastric acid, probably by increasing gastrin production [1,12,28]. Sorensen et al [20] and Dawson et al [5] found that bypass surgery has no important influence on the levels of gastrin produced. Junghanns et al [10] reported a less pronounced rise of serum gastrin levels after distal resection than after proximal resection (PR) in dogs.…”

Section: Discussionmentioning

confidence: 99%

Comparative effect of distal and proximal intestinal resection and bypass on the rat exocrine pancreas

et al. 1990

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We studied the effects of small-bowel resection and bypass on pancreatic function in rats subjected to a 50% distal resection (DR), a 50% proximal resection (PR), a 50% jejunal bypass (BP) or an intestinal transection (SH) (controls). Duodenal contents were collected after cannulation (under basal conditions). Afterwards, an in vivo duodenal perfusion was made using a glucose/saline solution and perfusate was collected for 1 h. Following this, a cholecystokinin (CCK) solution was injected into the jugular vein (1 U/kg body wt.) and perfusion continued for another 1 h. Basal duodenal volume only increased in rats with a PR, and no significant changes occurred in protein content. In basal conditions, no decreases in amylase, lipase, trypsin, or chymotrypsin activities after DR, PR or BP were detected. When animals were subjected to a perfusion and CCK stimulation, no significant changes occurred in animals with BP; the volume was maintained in rats with PR and DR but a decrease in protein and enzymatic contents was found. We concluded that, in basal conditions, the lack (resections) or exclusion (BP) of 50% of the small bowel does not negatively affect the digestive function. When however, a sustained activity is required, the extirpation of intestinal surface provokes a fall in enzymatic activities and is not modified if only the intestinal transit is suppressed, as occurs in the cases of BP.

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Gut and Pancreatic Hormones after Jejunoileal Bypass with 3:1 or 1:3 Jejunoileal Ratio

Cited by 23 publications

References 17 publications

Gastrointestinal surgery and gut hormones

Gastrointestinal surgery and gut hormones

Glucagon, Secretin and Vasoactive Intestinal Polypeptide Immunoreactivities in Rat Gut after Jejuno-Ileal Bypass and Resection

Comparative effect of distal and proximal intestinal resection and bypass on the rat exocrine pancreas

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