TY - JOUR
T1 - Mechanisms in bariatric surgery
T2 - Gut hormones, diabetes resolution, and weight loss
AU - Holst, Jens Juul
AU - Madsbad, Sten
AU - Bojsen-Møller, Kirstine N
AU - Svane, Maria Saur
AU - Jørgensen, Nils Bruun
AU - Dirksen, Carsten
AU - Martinussen, Christoffer
N1 - Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
PY - 2018/5
Y1 - 2018/5
N2 - Gastric bypass surgery leads to profound changes in the secretion of gut hormones with effects on metabolism, appetite, and food intake. Here, we discuss their contributions to the improvement in glucose tolerance and the weight loss that results from the operations. We find that the improved glucose tolerance is due the following events: a negative energy balance and resulting weight loss, which improve first hepatic and later peripheral insulin sensitivity, in combination with increased postprandial insulin secretion elicited particularly by exaggerated glucagon-like peptide-1 responses. The weight loss is due to loss of appetite resulting in reduced energy intake, and we find it probable that this process is driven by exaggerated secretion of appetite-regulating gut hormones including, but probably not limited to, glucagon-like peptide-1 and peptide-YY. The increased secretion is due to an accelerated exposure to and absorption of nutrients in the small intestine. This places the weight loss and the gut hormones in key positions with respect to the metabolic improvements after bypass surgery.
AB - Gastric bypass surgery leads to profound changes in the secretion of gut hormones with effects on metabolism, appetite, and food intake. Here, we discuss their contributions to the improvement in glucose tolerance and the weight loss that results from the operations. We find that the improved glucose tolerance is due the following events: a negative energy balance and resulting weight loss, which improve first hepatic and later peripheral insulin sensitivity, in combination with increased postprandial insulin secretion elicited particularly by exaggerated glucagon-like peptide-1 responses. The weight loss is due to loss of appetite resulting in reduced energy intake, and we find it probable that this process is driven by exaggerated secretion of appetite-regulating gut hormones including, but probably not limited to, glucagon-like peptide-1 and peptide-YY. The increased secretion is due to an accelerated exposure to and absorption of nutrients in the small intestine. This places the weight loss and the gut hormones in key positions with respect to the metabolic improvements after bypass surgery.
KW - Appetite/physiology
KW - Bariatric Surgery
KW - Diabetes Mellitus, Type 2/surgery
KW - Dietary Carbohydrates/metabolism
KW - Dietary Proteins/metabolism
KW - Digestion/physiology
KW - Eating/physiology
KW - Gastric Bypass
KW - Gastrointestinal Hormones/physiology
KW - Glucagon-Like Peptide 1/physiology
KW - Humans
KW - Insulin Resistance/physiology
KW - Intestinal Absorption/physiology
KW - Nutrients/metabolism
KW - Obesity, Morbid/complications
KW - Peptide YY/physiology
KW - Weight Loss/physiology
U2 - 10.1016/j.soard.2018.03.003
DO - 10.1016/j.soard.2018.03.003
M3 - Journal article
C2 - 29776493
SN - 1550-7289
VL - 14
SP - 708
EP - 714
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 5
ER -
