The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones

Abstract

Bariatric surgery for obesity has proved to be an extremely effective method of promoting long-term weight reduction with additional beneficial metabolic effects, such as improved glucose tolerance and remission of type 2 diabetes. A range of bariatric procedures are in common use, including gastric banding, sleeve gastrectomy and the Roux-en-Y gastric bypass. Although the mechanisms underlying the efficacy of bariatric surgery are unclear, gastrointestinal and pancreatic peptides are thought to play an important role. The aim of this review is to summarise the effects of different bariatric surgery procedures upon gastrointestinal and pancreatic peptides, including ghrelin, gastrin, cholecystokinin (CCK), glucose-dependent insulinotropic hormone (GIP), glucagon-like peptide 1 (GLP-1), peptide YY (PYY), oxyntomodulin, insulin, glucagon and somatostatin.

Nonalcoholic Fatty Liver Disease

“…Furthermore, GLP-1 effects modulate bile acid signalling, specifically through the farsenoid X receptor (FXR) which can alter the gut microbiome and can have other potential benefits. [213][214][215] However, practitioners and patients are reluctant to pursue bariatric surgery, even when patients are appropriate candidates. Although there are known complications that vary according to the procedure performed, the overall the risk is low in properly selected patients 216 .…”

Bariatric surgery and surgical devices in obesity management

“…20 In addition to restriction and malabsorption of food, there are a number of other mechanisms which contribute to weight loss including alteration of gut microbiota, action on signalling between gut and brain and impact on gut hormones such as reduced orexigenic hormones such as ghrelin and increased anorectic hormones such as GLP-1 and peptide YY postprandially, which also aid insulin secretion and glucose control. [21][22][23][24][25][26][27][28][29][30] Newer surgical techniques Not all patients benefit from the above standard bariatric procedures and several newer surgical techniques have been developed, some of which are described below.…”

Efeito da cirurgia bariátrica sobre parâmetros clínicos, laboratoriais e fatores de risco cardiovascular

“…Além disso, o GIP está associado a prevenção da apoptose das células beta e ao aumento no níveis de Glucagon no período pós-prandial 31 . Introdução 6 O CCK é também um hormônio incretínico produzido por sua vez no duodeno, região proximal do intestino delgado.…”

“…Este ainda promove liberação de enzimas pancreáticas, redução do esvaziamento gástrico e está associado à saciedade. O principal estímulo para sua liberação é a presença de aminoácidos e ácidos graxos no duodeno 31 .…”

“…Os resultados na literatura no entanto ainda são controversos o que pode ser decorrente de diferentes períodos de seguimento, diferentes intervenções e métodos de análise 31 .…”