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Obesity Surgery

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01-03-2018 | Original Contributions

A Meta-Analysis of GLP-1 After Roux-En-Y Gastric Bypass: Impact of Surgical Technique and Measurement Strategy

Authors: Pichamol Jirapinyo, David X. Jin, Taha Qazi, Nitin Mishra, Christopher C. Thompson

Published in: Obesity Surgery | Issue 3/2018

Abstract

Background

Roux-en-Y gastric bypass (RYGB) is an effective treatment for diabetes. Glucagon-like peptide-1 (GLP-1) is a gut hormone that is important to glucose homeostasis.

Objective

This study aimed to assess GLP-1 level and its predictors after RYGB.

Methods

The study design was a meta-analysis. The data sources were MEDLINE, EMBASE, Web of Science, and the Cochrane Databases. The study selection composed of studies with pre- and post-RYGB levels. The main outcomes were as follows: Primary outcome was the change in postprandial GLP-1 levels after RYGB. Secondary outcomes included the changes in fasting glucose, fasting insulin, and fasting GLP-1 levels after RYGB. Meta-regression to determine predictors of changes in GLP-1 levels was performed. Outcomes were reported using Hedge’s g.

Results

Twenty-four studies with 368 patients were included. Postprandial GLP-1 levels increased after RYGB (Hedge’s g = 1.29, p < 0.0001), while fasting GLP-1 did not change (p = 0.23). Peak postprandial GLP-1 levels gave the most consistent results (I ² = 9.11). Fasting glucose and insulin levels decreased after RYGB (p < 0.0001).

Roux limb length was a significant predictor for amount of GLP-1 increase (β = − 0.01, p = 0.02). Diabetes status, amount of weight loss, length of biliopancreatic limb, and time of measurement were not significant predictors (p > 0.05).

Conclusion

Postprandial GLP-1 levels increase after RYGB, while fasting levels remain unchanged. Shorter Roux limb length is associated with greater increase in postprandial GLP-1, which may lead to better glycemic control in this population.

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Title: A Meta-Analysis of GLP-1 After Roux-En-Y Gastric Bypass: Impact of Surgical Technique and Measurement Strategy
Authors: Pichamol Jirapinyo
David X. Jin
Taha Qazi
Nitin Mishra
Christopher C. Thompson
Publication date: 01-03-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 3/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-017-2913-1

ACC 2024 Congress

Springer Medicine

A Meta-Analysis of GLP-1 After Roux-En-Y Gastric Bypass: Impact of Surgical Technique and Measurement Strategy

Abstract

Background

Objective

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

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