OBJECTIVE: To compare the effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) on gastrointestinal and pancreatic peptide hormones.
METHODS: University hospital, China.
METHODS: A nonrandomized prospective study was conducted in Chinese obese patients undergoing LSG or LRYGB. Of 20 patients in this study, 10 underwent LSG, and 10 underwent LRYGB. Fasting plasma levels of insulin, glucagon, ghrelin, gastric inhibitory peptide, peptide YY, glucagon-like peptide (GLP)-1, and GLP-2 were measured preoperatively and at 1, 3, 6, and 12 months after surgery. This trial was registered at www.clinicaltrials.gov (NCT02963662).
RESULTS: During the first year after both operations, mean body mass index and fasting insulin levels steadily decreased at all intervals. Fasting plasma glucose levels significantly decreased at 1 month after surgery, then remained stable in both groups. Glucagon levels significantly decreased at 1, 3, and 6 months after surgery in both groups, but returned to baseline at 12 months. Fasting GLP-1 and peptide YY significantly increased in both groups, but more so after LRYGB. However, GLP-2 did not change in either group. Ghrelin levels significantly decreased after LSG, but not after LRYGB. Gastric inhibitory peptide levels decreased after LRYGB but not after LSG.
CONCLUSIONS: LSG and LRYGB resulted in significant and distinct changes in multiple gastrointestinal and pancreatic peptide hormones that are important regulators of obesity and metabolic health.
目的:比较腹腔镜袖状胃切除术(LSG)和腹腔镜Roux-en-Y胃旁路术(LRYGB)对胃肠和胰肽激素的影响。
方法:大学医院,中国。
方法:在接受LSG或LRYGB的中国肥胖患者中进行了一项非随机前瞻性研究。在这项研究中的20名患者中,10人接受了LSG,10人接受了LRYGB。空腹血浆胰岛素水平,胰高血糖素,ghrelin,抑胃肽,肽YY,术前以及术后1、3、6和12个月测量胰高血糖素样肽(GLP)-1和GLP-2。该试验已在www上注册。临床试验。gov(NCT02963662)。
结果:在两次手术后的第一年,平均体重指数和空腹胰岛素水平在所有时间间隔均稳定下降。术后1个月空腹血糖水平明显下降,然后两组保持稳定。两组患者术后1、3、6个月胰高血糖素水平均显著下降,但在12个月时恢复到基线。空腹GLP-1和肽YY在两组中显著增加,但在LRYGB之后更是如此。然而,两组GLP-2均无变化。Ghrelin水平在LSG后显著下降,但不是在LRYGB之后。LRYGB后胃抑制肽水平下降,但LSG后没有下降。
结论:LSG和LRYGB导致多种胃肠和胰腺肽激素发生显著和明显的变化,这些激素是肥胖和代谢健康的重要调节因子。