Changes in levels of selected incretins and appetite-controlling hormones following surgical treatment for morbid obesity

1 , Maciej Matlok 1 , Michal Pedziwiatr 1 Abstract Introduction: The hormonal brain-gut axis is a crucial element in appetite control and the response to surgical treat- ment for super obesity. However, mechanisms underlying the metabolic response to surgical treatment for morbid obesity are still not clearly specified. Aim: To evaluate and compare the effects of surgical treatment for super obesity by laparoscopic sleeve gastrectomy (LSG) and by laparoscopic Roux-en-Y gastric bypass (LRYGB) on selected incretins and appetite-controlling hormones. Material and methods: Thirty-five patients were enrolled in a prospective study. Laparoscopic sleeve gastrectomy was performed in 45.8% of patients, and LRYGB in the remaining 54.2% of patients. Before the procedure fasting blood serum was collected from patients and preserved, to determine levels of selected incretins and brain-gut hor- mones: glucagon-like peptide 1 (GLP-1), peptide YY (PYY), leptin, and ghrelin. Results: Twenty-eight patients came to a follow-up visit 12 months after the surgery. In these patients selected pa- rameters were determined again. The percentage weight loss was 58.8%. The ghrelin levels had decreased, and no statistically significant difference was observed between the two procedures. After both surgical procedures a statis- tically significant reduction in the leptin level was also observed. Peptide YY levels statistically significantly increased in the whole studied group. The GLP-1 level increased after the surgical procedure. However, the observed change was not statistically significant. Conclusions: Both treatment methods result in modification of secretion patterns for selected gastrointestinal hor - mones, and this was considered to be a beneficial effect of bariatric treatment. The laparoscopic sleeve gastrectomy, being a procedure resulting in a metabolic response, seems to be an equally effective method for treatment of super obesity and comorbidities as the laparoscopic gastric bypass.