The Links of Ghrelin to Incretins, Insulin, Glucagon, and Leptin After Bariatric Surgery

Abstract

Type 2 diabetes mellitus (T2DM) is one of the most prominent and socially significant problems. The present study aimed to identify the mechanisms of interaction of critical regulators of carbohydrate metabolism using bioinformatics and experimental methods and to assess their influence on the development of T2DM. We conducted an in silico search for the relationship of hormones and adipokines and performed functional annotation of the receptors for ghrelin and incretins. Hormones and adipokines were assessed in the plasma of obese patients with and without T2DM as well as after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) surgeries. Incretin- and ghrelin-associated functions and metabolic processes were discovered. Low ghrelin levels were observed in obese patients without T2DM compared with healthy volunteers and the other groups. The highest ghrelin levels were observed in obese patients with T2DM. This defense mechanism against insulin resistance could be realized through the receptors G-protein-coupled receptor (GPCR), growth hormone secretagogue receptor (GHSR), and growth hormone-releasing hormone receptor (GHRHR). These receptors are associated with proliferative, inflammatory, and neurohumoral signaling pathways and regulate responses to nutrient intake. Signaling through the GPCR class unites ghrelin, glucagon, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide (GLP)-1. Ghrelin impairs carbohydrate and lipid metabolism in obese patients. Ghrelin is associated with elevated plasma levels of insulin, glucagon, and leptin. Specific activation of receptors and modulation by posttranslational modifications of ghrelin can control IR’s development in obesity, which is a promising area for research.

Evaluation of Serum Ghrelin Level in Patients with Type 2 Diabetes Mellitus Before and After Supplementation of 5000 IU of Vitamin D

“…Ghrelin is a hormone that influences glucose and lipid metabolism in obese persons. A rise in insulin, glucagon, and leptin levels in the blood has been shown to be associated with ghrelin, according to Skuratovskaia et al 26 Specific activation of receptors and posttranslational modifications of ghrelin have been shown to be effective in controlling the development of IR in obese individuals. According to Stoica and colleagues 27 study, the metabolism of all adipokines is significantly dysregulated in obese people.…”

Mechanisms and Outcomes of Metabolic Surgery in Type 2 Diabetes

“…Ghrelin affects carbohydrate and lipid metabolism in obese patients. After RYGB and LSG surgeries, ghrelin was associated with elevated plasma levels of insulin, leptin, and glucagon [38].…”

Relationship to Bariatric Surgery and their Gastrointestinal Hormones: how we Weight Loss?

“…They are associated with carbohydrate metabolism, both by stimulating the release of insulin by pancreatic ÿ cells (responsible for half of the insulin synthesis) and by controlling leptin and ghrelin [11].…”

“…It is secreted by intestinal enteroendocrine L cells, ileum, colon, and some neuronal cells of the central nervous system.4 Like GIP, GLP-1 is an incretin; therefore, it is related to the regulation of carbohydrates, normalizing their metabolism, and promoting a reduction in the body mass index (BMI) [11].…”