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

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

Research output: Contribution to journalArticle

88 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1901-1911
Number of pages11
JournalDiabetologia
Volume51
Issue number10
DOIs
StatePublished - Oct 1 2008

Keywords

  • Clinical science
  • Cytokines
  • Gastro-entero pancreatic factors
  • Human
  • Insulin sensitivity and resistance
  • Other hormones
  • Other islet cells/hormones
  • Weight regulation and obesity

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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    Swarbrick, M. M., Stanhope, K. L., Austrheim-Smith, I. T., Van Loan, M. D., Ali, M. R., Wolfe, B. M., & Havel, P. J. (2008). Longitudinal changes in pancreatic and adipocyte hormones following Roux-en-Y gastric bypass surgery. Diabetologia, 51(10), 1901-1911. https://doi.org/10.1007/s00125-008-1118-5