Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass
Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass
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DOI：
10.1097/sla.0b013e3180caa3e3
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发表时间：
2007-11-01
影响因子：
9
通讯作者：
Olbers, Torsten
中科院分区：
文献类型：
--
作者：
le Roux, Carel W.;Welbourn, Richard;Olbers, Torsten
目的：评价饱腹感胃肠激素的生理重要性。背景：胃肠激素在控制食欲中的生理作用存在争议。减肥手术仍然是治疗肥胖症最有效的选择，胃肠激素参与了Roux-en-Y胃旁路术后食欲和体重的减少。方法：我们将胃旁路术后第一周内多肽YY(PYY)和胰高血糖素样肽1(GLP-1)的变化与食欲的变化联系起来。我们还评估了胃旁路手术后体重减轻好或差的患者的胃肠激素反应。最后，我们抑制胃转流患者的胃肠激素反应，然后评估食欲和食物摄入量。结果：餐后PYY和GLP-1的变化早在胃转流后2天就开始升高(P<；0.05)。胃旁路手术后几天内食欲明显改变(P<；0.05)，与其他手术不同的是，食欲下降仍在继续。然而，在胃旁路术后体重减轻较差并伴有食欲增加的患者中，与体重减轻良好的患者相比，餐后PYY和GLP-1的反应减弱(P<；0.05)。ASS灌胃后抑制胃肠激素反应，包括PYY和GLP-1，导致食欲恢复和摄食量增加(P<；0.05)。结论：胃旁路术后食欲减弱与PYY和GLP-1浓度升高有关，胃肠激素释放受到抑制后食欲恢复。这些结果提示胃肠激素在胃旁路手术后体重减轻的机制中起作用，并可能对肥胖症的治疗有一定的意义。
Objective: To evaluate the physiologic importance of the satiety gut hormones.Background: Controversy surrounds the physiologic role of gut hormones in the control of appetite. Bariatric surgery remains the most effective treatment option for obesity, and gut hormones are implicated in the reduction of appetite and weight after Roux-en-Y gastric bypass.Methods: We correlated peptide YY (PYY) and glucagon-like peptide 1 (GLP-1) changes within the first week after gastric bypass with changes in appetite. We also evaluated the gut hormone responses of patients with good or poor weight loss after gastric bypass. Finally, we inhibited the gut hormone responses in gastric bypass patients and then evaluated appetite and food intake.Results: Postprandial PYY and GLP-1 profiles start rising as early as 2 days after gastric bypass (P < 0.05). Changes in appetite are evident within days after gastric bypass surgery (P < 0.05), and unlike other operations, the reduced appetite continues. However, in patients with poor weight loss after gastric bypass associated with increased appetite, the postprandial PYY and GLP-1 responses are attenuated compared with patients with good weight loss (P < 0.05). Inhibiting gut hormone responses, including PYY and GLP-1 after gastric by ass, results in return of appetite and increased food intake (P < 0.05).Conclusion: The attenuated appetite after gastric bypass is associated with elevated PYY and GLP-1 concentrations, and appetite returns when the release of gut hormones is inhibited. The results suggest a role for gut hormones in the mechanism of weight loss after gastric bypass and may have implications for the treatment of obesity.