Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Obesity Reports
Erschienen in: Current Obesity Reports 2/2015

01.06.2015 | Obesity Treatment (CM Apovian, Section Editor)

Differences in Weight Loss and Gut Hormones: Rouen-Y Gastric Bypass and Sleeve Gastrectomy Surgery

Erschienen in: Current Obesity Reports | Ausgabe 2/2015

Einloggen, um Zugang zu erhalten

Abstract

Bariatric surgery is arguably the most effective therapy for weight loss, and Rouen-Y gastric bypass (RYGB) is considered the “gold-standard” procedure. However, sleeve gastrectomy (SG) surgery has become more prevalent in recent years and it is unclear if weight loss differences occur between these procedures. Herein, we discuss evidence from randomized clinical trials comparing the effectiveness of RYGB and SG on weight loss. Moreover, we highlight gut hormones (e.g., GLP-1, ghrelin, bile acids, etc.) as potentially important mechanisms that contribute to the durability of decreased appetite and opposed fat storage following RYGB and SG. Collectively, although a subtle (∼3–5 kg) weight loss difference may exist in favor of RYGB up to 3 years post-operation, it appears that RYGB and SG induce comparable weight loss and changes in gut physiology that parallel reduced disease risk. These findings are clinically relevant for optimizing treatment strategies that combat obesity-related diabetes and cardiovascular disease.
Literatur
1.
Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307(5):491–7.CrossRefPubMed
2.
Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA. 2006;295(13):1549–55.CrossRefPubMed
3.
4.
NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956-961.
5.
6.
Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev. 2014;8:CD003641.PubMed
7.
Gagner M, Deitel M, Kalberer TL, et al. The second international consensus summit for sleeve gastrectomy, March 19-21, 2009. Surg Obes Relat Dis. 2009;5(4):476–85.CrossRefPubMed
8.
Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254(3):410–20.CrossRefPubMedCentralPubMed
9.
Rubino F. Bariatric surgery: effects on glucose homeostasis. Curr Opin Clin Nutr Metab Care. 2006;9(4):497–507.CrossRefPubMed
10.
Karamanakos SN, Vagenas K, Kalfarentzos F, Alexandrides TK. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.CrossRefPubMed
11.•
Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740–8. This is randomized clinical trial demonstrates the complexity at which endocrine factors play a role in weight loss and glucose regulation between surgical procedures.
12.•
Keidar A, Hershkop KJ, Marko L, et al. Roux-en-Y gastric bypass vs sleeve gastrectomy for obese patients with type 2 diabetes: a randomised trial. Diabetologia. 2013;56(9):1914–8. This is one of the few randomized clinical trials examining body composition between surgical procedures.
13.
Nogués X, Goday A, Peña MJ, et al. Bone mass loss after sleeve gastrectomy: a prospective comparative study with gastric bypass. Cir Esp. 2010;88(2):103–9.CrossRefPubMed
14.
Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76.CrossRefPubMedCentralPubMed
15.•
Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13. This is one of the longest randomized clinical trials comparing surgical procedures.
16.
Paluszkiewicz R, Kalinowski P, Wróblewski T, et al. Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity. Wideochir Inne Tech Malo Inwazyjne. 2012;7(4):225–32.PubMedCentralPubMed
17.•
Vix M, Liu KH, Diana M, et al. Impact of Roux-en-Y gastric bypass versus sleeve gastrectomy on vitamin D metabolism: short-term results from a prospective randomized clinical trial. Surg Endosc. 2014;28(3):821–6. This is one of the few randomized clinical trials examining vitamin absorption between surgical procedures, and highlights the need for future work to assess dietary habits in post-operative patients.
18.
Ramón JM, Salvans S, Crous X, et al. Effect of Roux-en-Y gastric bypass vs sleeve gastrectomy on glucose and gut hormones: a prospective randomised trial. J Gastrointest Surg. 2012;16(6):1116–22.CrossRefPubMed
19.
Malin SK, Bena J, Abood B, et al. Attenuated improvements in adiponectin and fat loss characterize type 2 diabetes non-remission status after bariatric surgery. Diabetes Obes Metab. 2014;16(12):1230–8.CrossRefPubMed
20.•
Malin SK, Samat A, Wolski K, et al. Improved acylated ghrelin suppression at 2 years in obese patients with type 2 diabetes: effects of bariatric surgery vs standard medical therapy. Int J Obes. 2014;38(3):364–70. This is one of the few randomized clinical trials examining acylated ghrelin between surgical procedures in people with type 2 diabetes, and highlights that hormonal profiles are unique to the surgery performed on body fat.
21.•
Kashayp SR, Bhatt DL, Wolski K, et al. Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment. Diabetes Care. 2013;36(8):2175–82. This is one of the few randomized clinical trials examining body composition, gut hormones and insulin action between surgical procedures in people with type 2 diabetes, and highlights that hormonal profiles are unique to the surgery performed.
22.
Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258(4):628–36.PubMedCentralPubMed
23.
24.
Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med. 2002;346(21):1623–30.CrossRefPubMed
25.
Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22(9):947–54.CrossRefPubMed
26.
Brolin RE, LaMarca LB, Kenler HA, Cody RP. Malabsorptive gastric bypass in patients with superobesity. J Gastrointest Surg. 2002;6(2):195–203.CrossRefPubMed
27.
Rubino F, R’bibo SL, del Genio F, et al. Metabolic surgery: the role of the gastrointestinal tract in diabetes mellitus. Nat Rev Endocrinol. 2010;6(2):102–9.CrossRefPubMedCentralPubMed
28.
Kashyap SR, Gatmaitan P, Brethauer S, Schauer P. Bariatric surgery for type 2 diabetes: weighing the impact for obese patients. Cleve Clin J Med. 2010;77(7):468–76.CrossRefPubMedCentralPubMed
29.
Lim CT, Kola B, Korbonits M. AMPK as a mediator of hormonal signalling. J Mol Endocrinol. 2010;44(2):87–97.CrossRefPubMed
30.
Cummings DE. Endocrine mechanisms mediating remission of diabetes after gastric bypass surgery. Int J Obes (Lond). 2009;33 Suppl 1:S33–40.CrossRef
31.
Mithieux G. A novel function of intestinal gluconeogenesis: central signaling in glucose and energy homeostasis. Nutrition. 2009;25(9):881–4.CrossRefPubMed
32.
Rubino F, Gagner M, Gentileschi P, et al. The early effect of the Roux-en-Y gastric bypass on hormones involved in body weight regulation and glucose metabolism. Ann Surg. 2004;240(2):236–42.CrossRefPubMedCentralPubMed
33.
Salinari S, Debard C, Bertuzzi A, et al. Jejunal proteins secreted by db/db mice or insulin-resistant humans impair the insulin signaling and determine insulin resistance. PLoS One. 2013;8(2):e56258.CrossRefPubMedCentralPubMed
34.•
Saeidi N, Meoli L, Nestoridi E, Gupta NK, et al. Reprogramming of intestinal glucose metabolism and glycemic control in rats after gastric bypass. Science. 2013;341(6144):406–10. This study demonstrates unique adaptation in the gut that regulates glucose metabolism following gastric bypass. This has implications for influencing gut adaptation for endocrine-regulated weight loss.
35.
Holst JJ, Vilsbll T, Deacon CF. The incretin system and its role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009;297(1–2):127–36.CrossRefPubMed
36.
Laferrère B, Teixeira J, McGinty J, et al. Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes. J Clin Endocrinol Metab. 2008;93(7):2479–85.CrossRefPubMedCentralPubMed
37.
Samat A, Malin SK, Huang H, et al. Ghrelin suppression is associated with weight loss and insulin action following gastric bypass surgery at 12 months in obese adults with type 2 diabetes. Diabetes Obes Metab. 2013;15(10):963–6.CrossRefPubMed
38.
Nannipieri M, Mari A, Anselmino M, et al. The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab. 2011;96(9):E1372–9.CrossRefPubMed
39.•
Ramón JM, Salvans S, Crous X, et al. Effect of Roux-en-Y gastric bypass vs sleeve gastrectomy on glucose and gut hormones: a prospective randomised trial. J Gastrointest Surg. 2012;16(6):1116–22. This is one of the few randomized clinical trials examining gut hormones between surgical procedures, and highlights that hormonal profiles are unique to the surgery performed.
40.
Romero F, Nicolau J, Flores L, et al. Comparable early changes in gastrointestinal hormones after sleeve gastrectomy and Roux-En-Y gastric bypass surgery for morbidly obese type 2 diabetic subjects. Surg Endosc. 2012;26(8):2231–9.CrossRefPubMed
41.
42.
Korner J, Bessler M, Inabnet W, et al. Exaggerated glucagon-like peptide-1 and blunted glucose-dependent insulinotropic peptide secretion are associated with Roux-en-Y gastric bypass but not adjustable gastric banding. Surg Obes Relat Dis. 2007;3(6):597–601.CrossRefPubMedCentralPubMed
43.
Hanusch-Enserer U, Ghatei MA, Cauza E, et al. Relation of fasting plasma peptide YY to glucose metabolism and cardiovascular risk factors after restrictive bariatric surgery. Wien Klin Wochenschr. 2007;119(9–10):291–6.CrossRefPubMed
44.
le Roux CW, Aylwin SJ, Batterham RL, et al. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann Surg. 2006;243(1):108–14.CrossRefPubMedCentralPubMed
45.
Laferrère B, Swerdlow N, Bawa B. Rise of oxyntomodulin in response to oral glucose after gastric bypass surgery in patients with type 2 diabetes. J Clin Endocrinol Metab. 2010;95(8):4072–6.CrossRefPubMedCentralPubMed
46.
Tsoli M, Chronaiou A, Kehagias I, et al. Hormone changes and diabetes resolution after biliopancreatic diversion and laparoscopic sleeve gastrectomy: a comparative prospective study. Surg Obes Relat Dis. 2013;9(5):667–77.CrossRefPubMed
47.
Tong J, Prigeon RL, Davis HW, et al. Ghrelin suppresses glucose-stimulated insulin secretion and deteriorates glucose tolerance in healthy humans. Diabetes. 2010;59(9):2145–51.CrossRefPubMedCentralPubMed
48.
Falkén Y, Hellström PM, Holst JJ, Näslund E. Changes in glucose homeostasis after Roux-en-Y gastric bypass surgery for obesity at day three, two months, and one year after surgery: role of gut peptides. J Clin Endocrinol Metab. 2011;96(7):2227–35.CrossRefPubMed
49.
Ahmad NN, Pfalzer A, Kaplan LM. Roux-en-Y gastric bypass normalizes the blunted postprandial bile acid excursion associated with obesity. Int J Obes. 2013;37(12):1553–9.CrossRef
50.
Glicksman C, Pournaras DJ, Wright M, et al. Postprandial plasma bile acid responses in normal weight and obese subjects. Ann Clin Biochem. 2010;47(Pt 5):482–4.CrossRefPubMed
51.
Patti ME, Houten SM, Bianco AC, et al. Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism. Obesity (Silver Spring). 2009;17(9):1671–7.CrossRef
52.•
Pournaras DJ, Glicksman C, Vincent RP, et al. The role of bile after Roux-en-Y gastric bypass in promoting weight loss and improving glycaemic control. Endocrinology. 2012;153(8):3613–9. This is one of the few randomized clinical trials examining bile acids in regulating weight loss post-RYGB.
53.
Furet JP, Kong LC, Tap J, et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes. 2010;59(12):3049–57.CrossRefPubMedCentralPubMed
54.
Liou AP, Pazik M, Luevano Jr JM, et al. Conserved shifts in the gut microbiota due to gastric bypass reduce host weight and adiposity. Sci Transl Med. 2013;5(178):178ra41.CrossRefPubMedCentralPubMed
55.
Katsuma S, Hirasawa A, Tsujimoto G. Bile acids promote glucagon-like peptide-1 secretion through TGR5 in a murine enteroendocrine cell line STC-1. Biochem Biophys Res Commun. 2005;329(1):386–90.CrossRefPubMed
56.
57.
Düfer M, Hörth K, Wagner R, et al. Bile acids acutely stimulate insulin secretion of mouse β-cells via farnesoid X receptor activation and K(ATP) channel inhibition. Diabetes. 2012;61(6):1479–89.CrossRefPubMedCentralPubMed
58.
Lundåsen T, Gälman C, Angelin B, Rudling M. Circulating intestinal fibroblast growth factor 19 has a pronounced diurnal variation and modulates hepatic bile acid synthesis in man. J Intern Med. 2006;260(6):530–6.CrossRefPubMed
59.
Carrasco F, Papapietro K, Csendes A, et al. Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass. Obes Surg. 2007;17(5):608–16.CrossRefPubMed
60.
Stylopoulos N, Hoppin AG, Kaplan LM. Roux-en-Y gastric bypass enhances energy expenditure and extends lifespan in diet-induced obese rats. Obesity (Silver Spring). 2009;17(1):1839–47.CrossRef
61.•
Ryan KK, Tremaroll V, Clemmensen C, et al. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature. 2014;509(7499):183–8. This study eloquently highlights the role of bile acids on weight loss following SG in rodents.
62.
Ockenga J, Valentini L, Schuetz T, et al. Plasma bile acids are associated with energy expenditure and thyroid function in humans. J Clin Endocrinol Metab. 2012;97(2):535–42.CrossRefPubMed
63.
Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142(4):621–32.CrossRefPubMed
64.
Flum DR, Belle SH, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445–54.CrossRefPubMed
65.
Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355(8):763–78.CrossRefPubMed
66.
Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
67.
Davies DJ, Baxter JM, Baxter JN. Nutritional deficiencies after bariatric surgery. Obes Surg. 2007;17(9):1150–8.CrossRefPubMed
68.
Ritz P, Becouarn G, Douay O, et al. Gastric bypass is not associated with protein malnutrition in morbidly obese patients. Obes Surg. 2009;19(7):840–4.CrossRefPubMed
69.
Angstadt JD, Bodziner RA. Peripheral polyneuropathy from thiamine deficiency following laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15(6):890–2.CrossRefPubMed
70.
Goldfine AB, Mun EC, Devine E, et al. Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab. 2007;92(12):4678–85.CrossRefPubMed
71.
Service GJ, Thompson GB, Service FJ, et al. Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery. N Engl J Med. 2005;353(3):249–54.CrossRefPubMed
72.
Maggard-Gibbons M, Maglione M, Livhits M, et al. Bariatric surgery for weight loss and glycemic control in nonmorbidly obese adults with diabetes: a systematic review. JAMA. 2013;309(21):2250–61.CrossRefPubMed
Metadaten
Titel
Differences in Weight Loss and Gut Hormones: Rouen-Y Gastric Bypass and Sleeve Gastrectomy Surgery
Publikationsdatum
01.06.2015
Erschienen in
Current Obesity Reports / Ausgabe 2/2015
Elektronische ISSN: 2162-4968
DOI
https://doi.org/10.1007/s13679-015-0151-1

Weitere Artikel der Ausgabe 2/2015

Current Obesity Reports 2/2015 Zur Ausgabe

Obesity Treatment (CM Apovian, Section Editor)

Gut Microbiome and Obesity: A Plausible Explanation for Obesity

Obesity Treatment (CM Apovian, Section Editor)

The Interplay Between Sex, Ethnicity, and Adipose Tissue Characteristics

Obesity Prevention (A Must, Section Editor)

Social Relationships and Obesity: Benefits of Incorporating a Lifecourse Perspective

Obesity Prevention (A Must, Section Editor)

Prevention of Weight Regain Following Bariatric Surgery

Obesity Prevention (A Must, Section Editor)

Childhood Obesity Prevention in Childcare Settings: the Potential of Policy and Environmental Change Interventions

Obesity Prevention (A Must, Section Editor)

A Review of Primary Care-Based Childhood Obesity Prevention and Treatment Interventions

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Metformin rückt in den Hintergrund

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Thrombophiliescreening – Wenn, dann richtig und nur bei therapeutischer Konsequenz

24.04.2024 | DGIM 2024 | Nachrichten

Bei Senioren mit Prostatakarzinom auf Anämie achten!
weitere anzeigen

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise