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Preoperative assessment of gut hormones does not correlate to weight loss after Roux-en-Y gastric bypass surgery
Affiliation:1. Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Department of Molecular, Cellular and Biomedical Sciences, Sophie Davis School of Biomedical Education, City University of New York School of Medicine, NY, USA
Abstract:BackgroundRoux-en-Y gastric bypass (RYGB) surgery is an effective and frequently used surgical treatment for severe obesity. Postoperative weight loss varies markedly, but biomarkers to predict weight loss outcomes remain elusive. Levels of the satiety gut hormones glucagon like peptide-1 (GLP-1) and peptide YY (PYY) are attenuated in obese patients but elevated after RYGB surgery. We aimed to evaluate the preoperative responses of GLP-1 and PYY to a standard meal as a predictor of weight loss after RYGB surgery. We hypothesized that weak satiety gut hormone responses preoperatively, would predict poor weight loss after RYGB surgery.MethodsPreoperatively 43 patients (F = 25/M = 18) had GLP-1 and PYY measured in the fasting state and at 30-minute intervals over 180 minutes after a standard 400 kcal mixed meal. Weight loss was assessed at weight stability after surgery (mean 16.2 mo [CI 15.516.9]).ResultsBody mass index decreased from 44.0 kg/m2 (CI 42.2–45.7) before surgery to 30.3 kg/m2 (CI 28.4–32.2) after surgery (P<.001). Preoperative GLP-1 and PYY responses to food intake; as delta value between fasting and maximum as well as total responses during 180 minutes did not correlate to total weight loss (GLP-1; rho = .060 and rho = −.089, PYY; rho = −.03 and rho = −.022, respectively) or to excess weight loss % (GLP-1; rho = .051 and rho = −.064, PYY; rho = −.1 and rho = −.088, respectively).ConclusionPreoperative responses of GLP-1 and PYY to a 400 kcal mixed meal do not correlate to postoperative weight loss after RYGB surgery for morbid obesity.
Keywords:Gastric bypass  Bariatric surgery  Obesity  Weight change  Weight loss  Predictive factor  Predictive value of tests  Outcome assessment (Healthcare)  Glucagon like peptide-1  GLP-1  Peptide YY  PYY  Gastrointestinal hormones
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