Effect of Resected Gastric Volume on Ghrelin and GLP-1 Plasma Levels: a Prospective Study

• Published in: Journal of gastrointestinal surgery Vol. 20; no. 12; pp. 1931 - 1941
• Main Authors: Sista, Federico, Abruzzese, Valentina, Clementi, Marco, Carandina, Sergio, Amicucci, Gianfranco
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2016; Springer Nature B.V
• Subjects: Adult; Bariatric Surgery; Catheters; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Female; Gastrectomy - methods; Gastroenterology; Gastrointestinal surgery; Ghrelin - blood; Glucagon-Like Peptide 1 - blood; Glucose; Glucose Tolerance Test; Humans; Insulin - blood; Insulin - metabolism; Insulin Resistance; Insulin Secretion; Laparoscopy; Male; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Obesity; Obesity, Morbid - complications; Obesity, Morbid - surgery; Organ Size; Original Article; Plasma; Postoperative Period; Preoperative Period; Prospective Studies; Stomach - pathology; Stomach - surgery; Surgeons; Surgery; Weight control; Italy; Obesity; Volume resected; Diabetes mellitus type 2; Bariatric surgery; Sleeve gastrectomy
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-016-3292-y

Background
The correlation between resected gastric volume (RGV) and neuro-humoral changes (ghrelin and GLP-1) after laparoscopic sleeve gastrectomy (LSG) and their effects on type 2 diabetes mellitus (T2DM) has been evaluated.
Materials
Ninety-eight patients were divided in two groups: RGV <1200 mL (group A: 53 pts) and RGV >1200 mL (group B: 45 pts). Insulin secretion (insulin area under the curve (AUC)), insulinogenic index (IGI) and insulin-resistance (homeostasis model assessment, HOMA
IR
) were assessed before and after surgery (at the 3rd day and 6, 12 and 24 months after LSG) using the oral glucose tolerance test (OGTT). At the same time, ghrelin and GLP-1 levels were determined.
Results
A significant difference in T2DM resolution rate was observed after 6, 12 and 24 months in favour of RGV >1200 mL. Group B performed better than group A at the 3rd day and at the 6th, 12th and 24th months with regard to AUC, IGI and HOMA
IR
. In both groups, OGTT resulted in decreased ghrelin values and a significant increase in GLP-1 values for group B at the 3rd day and at the 6th and 12th months with no difference at the 24th month.
Conclusion
Ghrelin and GLP-1 changes play a role in the regulation of glucose metabolism during the 1st year after LSG. RGV influences ghrelin and GLP-1 plasma levels after LSG, with a significant improvement in the T2DM control.