Plasma Cholecystokinin Levels after Vertical Banded Gastroplasty: Effects of an Acidified Meal

Foschi, Diego; Corsi, Fabio; Pisoni, Luca; Vago, Tarcisio; Bevilacqua, Maurizio; Asti, Emanuele; Righi, I.; Trabucchi, E

doi:10.1381/096089204323093426

Cited by 24 publications

(18 citation statements)

References 19 publications

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“…52,152,153 One study found that, 120 days after VBG, the plasma CCK response to an acidified meal was faster and with a higher peak than before surgery, though the total AUC was not different. 154 Ockander and coworkers 155 found an increased density of CCK cells in the duodenal mucosa of patients post-JIB, but the significance of this finding is not clear.…”

Section: Cholecystokininmentioning

confidence: 97%

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Ionut

Bergman

2011

J Diabetes Sci Technol

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Obesity has increased alarmingly in the United States and is increasing in many countries of the world. Because obesity is an important risk factor for type 2 diabetes and other chronic diseases, it is important to develop approaches to counter the rapid increase in adiposity. One approach is bariatric surgery, the most successful clinical intervention known for treating obesity. Surgery can result in impressive weight loss and improvement of obesity-related comorbidities. Yet the mechanisms responsible for this remarkable effect of surgery remain controversial. It is now clear that caloric restriction, per se, does not explain all the reduction in stored fat mass after surgery. A number of gastrointestinal hormones, including glucagon-like peptide (GLP)-1, peptide YY, oxyntomodulin, GLP-2, glucose-dependent insulinotropic polypeptide, ghrelin, and others, can play roles in energy homeostasis and could be involved in bariatric-surgery-related weight loss and weight loss maintenance. Vagal innervation may play a role. In addition, there may be other yet-uncharacterized factors that could participate. This review discusses the possible roles of these hormonal mechanisms in various types of bariatric surgery to help elucidate some of the potential mechanisms at play in short-term and long-term post-bariatric surgery weight loss. Understanding such mechanisms could lead to new and efficacious means to control or even reduce the epidemic of obesity.

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Section: Cholecystokininmentioning

confidence: 97%

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Ionut

Bergman

2011

J Diabetes Sci Technol

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“…In some studies, lower fasting ghrelin levels were reported after laparoscopic sleeve gastrectomy (SG) [88,89]; while other findings showed increases in fasting ghrelin following LAGB [90–92]. A rise in ghrelin concentrations following both AGB [93,94] and VGB [92,95,96], have been widely observed, but several studies have noted no change following either procedure [97–100], and two cross-sectional studies found a reduction in ghrelin concentrations following AGB, in comparison to BMI-matched counterparts [101,102]. …”

Section: Interactions Between Gut Peptides and Brain Systems Relevmentioning

confidence: 99%

The neurohormonal regulation of energy intake in relation to bariatric surgery for obesity

Ochner

Gibson

Carnell

et al. 2010

Physiology & Behavior

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Obesity has reached pandemic proportions, with bariatric surgery representing the only currently available treatment demonstrating long-term effectiveness. Over 200,000 bariatric procedures are performed each year in the US alone. Given the reliable and singular success of bariatric procedures, increased attention is being paid to identifying the accompanying neurohormonal changes that may contribute to the resulting decrease in energy intake. Numerous investigations of postsurgical changes in gut peptides have been conducted, suggesting greater alterations in endocrine function in combination restrictive and malabsorptive procedures (e.g., Roux-en-Y gastric bypass) as compared to purely restrictive procedures (e.g., gastric banding), which may contribute to the increased effectiveness of combination procedures. However, very few studies have been performed and relatively little is known about changes in neural activation that may result from bariatric procedures, which likely interact with changes in gut peptides to influence postsurgical caloric intake. This review provides a background in the neurohormonal regulation of energy intake and discusses how differing forms of bariatric surgery may affect the neurohormonal network, with emphasis on Roux-en-Y gastric bypass, the most commonly performed procedure worldwide. The paper represents an invited review by a symposium, award winner or keynote speaker at the Society for the Study of Ingestive Behavior [SSIB] Annual Meeting in Portland, July 2009.

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“…7 These effects are probably related to endocrine or paracrine effects of the operations. Vertical banded gastroplasty increases post-meal cholecystokinin plasma levels, 8 whereas Roux-en-Y gastric by-pass inhibits basal and post-prandial ghrelin plasma levels 9 and increases peptideYY (PYY) concentrations. 10 Jejuno-ileal by-pass increases cholecystokinin, motilin, glucagon-like peptide 1 and PYY, 11 delays gastric emptying and reduces hunger sensations.…”

Section: Introductionmentioning

confidence: 99%

Treatment of morbid obesity by intraparietogastric administration of botulinum toxin: a randomized, double-blind, controlled study

et al. 2006

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Objective: The stomach is the main target organ for bariatric surgery, but no medical treatment has been developed to increase satiety and decrease food intake via gastric pathways. The aim of our study was to investigate whether or not the intraparietogastric administration of botulinum toxin A (BTX), able to modify the motility patterns of the stomach, could be useful for treatment of obesity. Design: Double blind controlled study. Subjects: Twenty-four morbidly obese patients (mean weight (s.e.m.) 116.174.89 kg, mean body mass index (BMI) 43.671.09 kg/m 2 ) were blindly randomized to receive 200 IU BTX or placebo into the antrum and fundus of the stomach by intraparietal endoscopic administration. Measurements: We evaluated weight loss, BMI changes, satiety score, the maximal gastric capacity for liquids and the gastric emptying time (octanoic acid breath test). Results: The two groups were homogeneous for anthropometric characteristics. Eight weeks after treatment, BTX patients had significantly higher weight loss (1171.09 vs 5.771.1 kg, Po0.001) and BMI reduction (470.36 vs 270.58 kg/m 2 , Po0.001) and a higher satiety score on a visual analogic scale (7.6370.38 vs 4.7270.44, Po0.001) than controls. Furthermore, BTX patients showed a significantly greater reduction in maximal gastric capacity for liquids (266.6748 vs 139731, Po0.001) and a greater prolongation in gastric emptying time ( þ 18.9378 vs À2.276.9 min, Po0.05). No significant side effects or neurophysiologic changes were found. Conclusions: Topical intragastric BTX was effective in reducing food intake and body weight in morbidly obese patients.

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Plasma Cholecystokinin Levels after Vertical Banded Gastroplasty: Effects of an Acidified Meal

Abstract: VBG increases the peak of CCK secretion and shortens the time to reach it. These changes could contribute to the satiety effects of gastric restrictive operations.

Cited by 24 publications

References 19 publications

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

Mechanisms Responsible for Excess Weight Loss after Bariatric Surgery

The neurohormonal regulation of energy intake in relation to bariatric surgery for obesity

Treatment of morbid obesity by intraparietogastric administration of botulinum toxin: a randomized, double-blind, controlled study

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