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Diabetologia
Published in: Diabetologia 10/2008

01-10-2008 | Article

Longitudinal changes in pancreatic and adipocyte hormones following Roux-en-Y gastric bypass surgery

Authors: M. M. Swarbrick, K. L. Stanhope, I. T. Austrheim-Smith, M. D. Van Loan, M. R. Ali, B. M. Wolfe, P. J. Havel

Published in: Diabetologia | Issue 10/2008

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Abstract

Aims/hypothesis

Bariatric surgery is an effective treatment for severe obesity, as in addition to dramatic weight loss, co-morbidities such as type 2 diabetes are frequently resolved. Although altered gastrointestinal peptide hormone secretion and its relationship with post-surgical improvements in insulin sensitivity has been studied, much less is known about long-term changes in pancreatic and adipose tissue-derived hormones. Our objective was to conduct a comprehensive longitudinal investigation of the endocrine changes following Roux-en-Y gastric bypass surgery (RYGBP), focusing on pancreatic and adipocyte hormones and systemic markers of inflammation.

Methods

Nineteen severely obese women (BMI 45.6 ± 1.6 kg/m2) were studied prior to RYGBP, and at 1, 3, 6, and 12 months after RYGBP. Body composition was assessed before surgery and at 1 and 12 months.

Results

Pre-surgical adiposity was correlated with circulating adipocyte hormones (leptin, visfatin) and inflammatory molecules (IL-6, high sensitivity C-reactive protein [hsCRP], monocyte chemoattractant protein-1). As expected, RYGBP reduced fat mass and fasting insulin and glucose concentrations. In addition, reductions of fasting pancreatic polypeptide (PP) and glucagon concentrations were observed at 1 and 3 months, respectively. In the 12 months following RYGBP, concentrations of most adipocyte hormones (leptin, acylation-stimulating hormone and visfatin, but not retinol-binding hormone-4) and inflammatory molecules (IL-6, hsCRP and soluble intracellular adhesion molecule-1) were significantly reduced. Reductions of insulin resistance (measured by homeostasis model assessment of insulin resistance) were independently associated with changes of glucagon, visfatin and PP. Pre-surgical HMW adiponectin concentrations independently predicted losses of body weight and fat mass.

Conclusions/interpretation

These results suggest that pancreatic and adipocyte hormones may contribute to the long-term resolution of insulin resistance after RYGBP.
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Metadata
Title
Longitudinal changes in pancreatic and adipocyte hormones following Roux-en-Y gastric bypass surgery
Authors
M. M. Swarbrick
K. L. Stanhope
I. T. Austrheim-Smith
M. D. Van Loan
M. R. Ali
B. M. Wolfe
P. J. Havel
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 10/2008
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-008-1118-5

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