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Submitted on April 26, 2005
Accepted on February 6, 2006
Obesity Unit, Biological Diagnostics Department, and Gastroenterology Department, Hospital Clínic Universitari, Barcelona, Spain
* To whom correspondence should be addressed. E-mail: jovidal{at}clinic.ub.es.
Context: The mechanisms underlying weight loss following Roux-en-Y Gastric Bypass (RYGBP) are not well understood.
Objective: To assess the changes in active glucagon-like peptide 1 (GLP-1), and total peptide YY (PYY) following RYGBP, and to examine their relationship with changes in hunger and satiety.
Design: Prospective study on the changes in active GLP-1, PYY, hunger, and satiety in response to a standardized test meal (STM) in 9 normal-glucose-tolerant obese subjects (BMI 47.4 ± 6.1 kg/m2) before and 6-weeks after RYGBP.
Results: Before surgery, meal ingestion failed to stimulate GLP-1 and PYY secretion. 6-weeks after surgery, despite subjects still being markedly obese (BMI 43.6 ± 7.8 kg/m2), the AUC0-120' of GLP-1 and of PYY in response to the STM were significantly elevated (P < 0.05 and P < 0.01, respectively). These hormonal responses were significantly larger (P < 0.01) than those observed in a group matched for the BMI attained 6-weeks after surgery. The 2.9 ± 1.2- and 1.6 ± 1.9-fold increase, respectively, in the AUC0-120' of GLP-1 and of PYY were accompanied by a significant decrease in fasting (P < 0.05) and post-prandial hunger (P = 0.05) and a significant increase in satiety (P < 0.05) following meal intake. Nevertheless, a significant was not found correlation between changes in the hormonal and eating behavior parameters.
Conclusion: Our data show that RYGBP is associated with an improvement in the active GLP-1 and total PYY response to a liquid-meal intake. Moreover, we provide circumstantial evidence for a potential role of these gastrointestinal hormones on the decreased appetite following RYGBP.
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