Changes in Fasting and Prandial Gut and Adiposity Hormones Following Vertical Sleeve Gastrectomy or Roux-en-Y-Gastric Bypass: an 18-Month Prospective Study

Naji Alamuddin, Marion L. Vetter, Rexford S. Ahima, Louise Hesson, Scott Ritter, Alyssa Minnick, Lucy F. Faulconbridge, Kelly C. Allison, David B. Sarwer, Jesse Chittams, Noel N. Williams, Matthew R. Hayes, James W. Loughead, Ruben Gur, Thomas A. Wadden

Research output: Research - peer-reviewArticle

Abstract

Background: Vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) produce substantial weight loss, both primarily through gastric restriction but with potentially different hormonal signaling. This prospective, observational study compared changes in gut-derived hormones in VSG, RYGB, and weight-stable participants at 6 and 18 months post-surgery. Methods: Sixty-four obese, non-diabetic women, including 18 VSG, 23 RYGB, and 23 weight-stable controls completed assessments at baseline and 6 months, before and after consuming a mixed-nutrient meal; blood sampling occurred for 180 min post-meal. Fifty-one participants completed the 18-month outcome. Change from baseline in post-prandial area under the curve (over 180 min) for GLP-1, PYY3–36, ghrelin, and leptin was measured at 6 and 18 months post-surgery. Results: At 18 months, VSG and RYGB participants lost a mean (±SEM) of 25.5 ± 2.3% and 34.2 ± 4.2% of initial weight, respectively (p < 0.156), which both differed (p < 0.001) from the +1.7 ± 1.0% gain in the control group. Fasting ghrelin declined significantly more in VSG than RYGB participants at both months 6 (p = 0.0199) and 18 (p = 0.0003). In response to the mixed-nutrient meal, GLP-1 and PYY3–36 demonstrated an exaggerated post-prandial response that was significantly greater in RYGB than VSG at 6 months (p < 0.0001 and p = 0.0062, respectively) but not 18 months (p = 0.0296 and p = 0.1210). Conclusions: VSG and RYGB both produced substantial weight losses at 18 months. The data suggest a role of gastrointestinal hormones as mediators of weight loss.

LanguageEnglish (US)
Pages1-10
Number of pages10
JournalObesity Surgery
DOIs
StateAccepted/In press - Dec 21 2016

Fingerprint

Gastric Bypass
Adiposity
Gastrectomy
Meals
Fasting
Hormones
Prospective Studies
Weight Loss
Weights and Measures
Ghrelin
Glucagon-Like Peptide 1
Food
Gastrointestinal Hormones
Leptin
Area Under Curve
Observational Studies
Stomach
Control Groups

Keywords

  • Bariatric surgery
  • Hormone
  • Obesity
  • Roux-en-Y gastric bypass
  • Weight loss, vertical sleeve gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Changes in Fasting and Prandial Gut and Adiposity Hormones Following Vertical Sleeve Gastrectomy or Roux-en-Y-Gastric Bypass : an 18-Month Prospective Study. / Alamuddin, Naji; Vetter, Marion L.; Ahima, Rexford S.; Hesson, Louise; Ritter, Scott; Minnick, Alyssa; Faulconbridge, Lucy F.; Allison, Kelly C.; Sarwer, David B.; Chittams, Jesse; Williams, Noel N.; Hayes, Matthew R.; Loughead, James W.; Gur, Ruben; Wadden, Thomas A.

In: Obesity Surgery, 21.12.2016, p. 1-10.

Research output: Research - peer-reviewArticle

Alamuddin, N, Vetter, ML, Ahima, RS, Hesson, L, Ritter, S, Minnick, A, Faulconbridge, LF, Allison, KC, Sarwer, DB, Chittams, J, Williams, NN, Hayes, MR, Loughead, JW, Gur, R & Wadden, TA 2016, 'Changes in Fasting and Prandial Gut and Adiposity Hormones Following Vertical Sleeve Gastrectomy or Roux-en-Y-Gastric Bypass: an 18-Month Prospective Study' Obesity Surgery, pp. 1-10. DOI: 10.1007/s11695-016-2505-5
Alamuddin, Naji ; Vetter, Marion L. ; Ahima, Rexford S. ; Hesson, Louise ; Ritter, Scott ; Minnick, Alyssa ; Faulconbridge, Lucy F. ; Allison, Kelly C. ; Sarwer, David B. ; Chittams, Jesse ; Williams, Noel N. ; Hayes, Matthew R. ; Loughead, James W. ; Gur, Ruben ; Wadden, Thomas A./ Changes in Fasting and Prandial Gut and Adiposity Hormones Following Vertical Sleeve Gastrectomy or Roux-en-Y-Gastric Bypass : an 18-Month Prospective Study. In: Obesity Surgery. 2016 ; pp. 1-10
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abstract = "Background: Vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) produce substantial weight loss, both primarily through gastric restriction but with potentially different hormonal signaling. This prospective, observational study compared changes in gut-derived hormones in VSG, RYGB, and weight-stable participants at 6 and 18 months post-surgery. Methods: Sixty-four obese, non-diabetic women, including 18 VSG, 23 RYGB, and 23 weight-stable controls completed assessments at baseline and 6 months, before and after consuming a mixed-nutrient meal; blood sampling occurred for 180 min post-meal. Fifty-one participants completed the 18-month outcome. Change from baseline in post-prandial area under the curve (over 180 min) for GLP-1, PYY3–36, ghrelin, and leptin was measured at 6 and 18 months post-surgery. Results: At 18 months, VSG and RYGB participants lost a mean (±SEM) of 25.5 ± 2.3% and 34.2 ± 4.2% of initial weight, respectively (p < 0.156), which both differed (p < 0.001) from the +1.7 ± 1.0% gain in the control group. Fasting ghrelin declined significantly more in VSG than RYGB participants at both months 6 (p = 0.0199) and 18 (p = 0.0003). In response to the mixed-nutrient meal, GLP-1 and PYY3–36 demonstrated an exaggerated post-prandial response that was significantly greater in RYGB than VSG at 6 months (p < 0.0001 and p = 0.0062, respectively) but not 18 months (p = 0.0296 and p = 0.1210). Conclusions: VSG and RYGB both produced substantial weight losses at 18 months. The data suggest a role of gastrointestinal hormones as mediators of weight loss.",
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author = "Naji Alamuddin and Vetter, {Marion L.} and Ahima, {Rexford S.} and Louise Hesson and Scott Ritter and Alyssa Minnick and Faulconbridge, {Lucy F.} and Allison, {Kelly C.} and Sarwer, {David B.} and Jesse Chittams and Williams, {Noel N.} and Hayes, {Matthew R.} and Loughead, {James W.} and Ruben Gur and Wadden, {Thomas A.}",
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T1 - Changes in Fasting and Prandial Gut and Adiposity Hormones Following Vertical Sleeve Gastrectomy or Roux-en-Y-Gastric Bypass

T2 - Obesity Surgery

AU - Alamuddin,Naji

AU - Vetter,Marion L.

AU - Ahima,Rexford S.

AU - Hesson,Louise

AU - Ritter,Scott

AU - Minnick,Alyssa

AU - Faulconbridge,Lucy F.

AU - Allison,Kelly C.

AU - Sarwer,David B.

AU - Chittams,Jesse

AU - Williams,Noel N.

AU - Hayes,Matthew R.

AU - Loughead,James W.

AU - Gur,Ruben

AU - Wadden,Thomas A.

PY - 2016/12/21

Y1 - 2016/12/21

N2 - Background: Vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) produce substantial weight loss, both primarily through gastric restriction but with potentially different hormonal signaling. This prospective, observational study compared changes in gut-derived hormones in VSG, RYGB, and weight-stable participants at 6 and 18 months post-surgery. Methods: Sixty-four obese, non-diabetic women, including 18 VSG, 23 RYGB, and 23 weight-stable controls completed assessments at baseline and 6 months, before and after consuming a mixed-nutrient meal; blood sampling occurred for 180 min post-meal. Fifty-one participants completed the 18-month outcome. Change from baseline in post-prandial area under the curve (over 180 min) for GLP-1, PYY3–36, ghrelin, and leptin was measured at 6 and 18 months post-surgery. Results: At 18 months, VSG and RYGB participants lost a mean (±SEM) of 25.5 ± 2.3% and 34.2 ± 4.2% of initial weight, respectively (p < 0.156), which both differed (p < 0.001) from the +1.7 ± 1.0% gain in the control group. Fasting ghrelin declined significantly more in VSG than RYGB participants at both months 6 (p = 0.0199) and 18 (p = 0.0003). In response to the mixed-nutrient meal, GLP-1 and PYY3–36 demonstrated an exaggerated post-prandial response that was significantly greater in RYGB than VSG at 6 months (p < 0.0001 and p = 0.0062, respectively) but not 18 months (p = 0.0296 and p = 0.1210). Conclusions: VSG and RYGB both produced substantial weight losses at 18 months. The data suggest a role of gastrointestinal hormones as mediators of weight loss.

AB - Background: Vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) produce substantial weight loss, both primarily through gastric restriction but with potentially different hormonal signaling. This prospective, observational study compared changes in gut-derived hormones in VSG, RYGB, and weight-stable participants at 6 and 18 months post-surgery. Methods: Sixty-four obese, non-diabetic women, including 18 VSG, 23 RYGB, and 23 weight-stable controls completed assessments at baseline and 6 months, before and after consuming a mixed-nutrient meal; blood sampling occurred for 180 min post-meal. Fifty-one participants completed the 18-month outcome. Change from baseline in post-prandial area under the curve (over 180 min) for GLP-1, PYY3–36, ghrelin, and leptin was measured at 6 and 18 months post-surgery. Results: At 18 months, VSG and RYGB participants lost a mean (±SEM) of 25.5 ± 2.3% and 34.2 ± 4.2% of initial weight, respectively (p < 0.156), which both differed (p < 0.001) from the +1.7 ± 1.0% gain in the control group. Fasting ghrelin declined significantly more in VSG than RYGB participants at both months 6 (p = 0.0199) and 18 (p = 0.0003). In response to the mixed-nutrient meal, GLP-1 and PYY3–36 demonstrated an exaggerated post-prandial response that was significantly greater in RYGB than VSG at 6 months (p < 0.0001 and p = 0.0062, respectively) but not 18 months (p = 0.0296 and p = 0.1210). Conclusions: VSG and RYGB both produced substantial weight losses at 18 months. The data suggest a role of gastrointestinal hormones as mediators of weight loss.

KW - Bariatric surgery

KW - Hormone

KW - Obesity

KW - Roux-en-Y gastric bypass

KW - Weight loss, vertical sleeve gastrectomy

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