Medical and Surgical Treatments for Obesity Have Opposite Effects on Peptide YY and Appetite: A Prospective Study Controlled for Weight Loss

• Published in: The journal of clinical endocrinology and metabolism Vol. 95; no. 3; pp. 1069 - 1075
• Main Authors: Valderas, Juan P, Irribarra, Verónica, Boza, Camilo, de la Cruz, Rolando, Liberona, Yessica, Acosta, Ana Maria, Yolito, Macarena, Maiz, Alberto
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01-03-2010; Copyright by The Endocrine Society
• Subjects: Adult; Analysis of Variance; Area Under Curve; Biological and medical sciences; Body Mass Index; Diet Therapy; Endocrinopathies; Exercise; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastrectomy; Gastric Bypass; Humans; Hunger - physiology; Male; Medical sciences; Middle Aged; Obesity - blood; Obesity - therapy; Patient Selection; Peptide YY - blood; Prospective Studies; Radioimmunoassay; Regression Analysis; Satiation - physiology; Time Factors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Weight Loss - physiology; Appetite; Obesity; Nutrition; Nutrition disorder; Weight loss; Metabolic diseases; Prospective; Chemotherapy; Treatment; Surgery; YY peptide; Endocrinology; Nutritional status
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2009-0983

Context: The effects of medical and surgical treatments for obesity on peptide YY (PYY) levels, in patients with similar weight loss, remain unclear.
Objective: The objective of the study was to assess PYY and appetite before and after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and medical treatment (MED).
Design: This was a prospective, controlled, nonrandomized study.
Setting: The study was conducted at the Departments of Nutrition and Digestive Surgery at a university hospital.
Participants: Participants included three groups of eight patients with similar body mass indexes (RYGB 37.8 ± 0.8, SG 35.3 ± 0.7, and MED 39.1 ± 1.7 kg/m2, P = NS) and eight lean controls (body mass index 21.7 ± 0.7 kg/m2).
Main Outcome Measures: Total plasma PYY, hunger, and satiety visual analog scales in fasting and after ingestion of a standard test meal were measured.
Results: At baseline there were no differences in the area under the curve (AUC) of PYY, hunger, or satiety in obese groups. Two months after the interventions, RYGB, SG, and MED groups achieved similar weight loss (17.7 ± 3, 14.9 ± 2.4, 16.6 ± 4%, respectively, P = NS). PYY AUC increased in RYGB (P < 0.001) and SG (P < 0.05) and did not change in MED. PYY levels decreased at fasting, 30 min, and 180 min after a standard test meal in MED (P < 0.05). Hunger AUC decreased in RYGB (P < 0.05). Satiety AUC increased in RYGB (P < 0.05) and SG (P < 0.05). Appetite did not change in MED. PYY AUC correlated with satiety AUC (r = 0.35, P < 0.05).
Conclusion: RYGB and SG increased PYY and reduced appetite. MED failed to produce changes. Different effects occur despite similar weight loss. This suggests that the weight-loss effects of these procedures are enhanced by an increase in PYY and satiety.
Gastric bypass and sleeve gastrectomy increased postprandial peptide YY and reduced appetite, but medical treatment failed to produce these changes despite achieving a similar weight loss.