Cited by 91Bariatric Surgery and OutcomesRegulation of Appetite and ObesityGastrointestinal motility and disorders

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Gut adaptation after metabolic surgery and its influences on the brain, liver and cancer

Sinclair, Piriyah, Brennan, Donal J., le Roux, Carel W.·2018·Nature Reviews Gastroenterology & Hepatology

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Abstract

Metabolic surgery is the best treatment for long-term weight loss maintenance and comorbidity control. Metabolic operations were originally intended to change anatomy to alter behaviour, but we now understand that the anatomical changes can modulate physiology to change behaviour. They are no longer considered only mechanically restrictive and/or malabsorptive procedures; rather, they are considered metabolic procedures involving complex physiological changes, whereby gut adaptation influences signalling pathways in several other organs, including the liver and the brain, regulating hunger, satiation, satiety, body weight, glucose metabolism and immune functions. The integrative physiology of gut adaptation after these operations consists of a complex mechanistic web of communication between gut hormones, bile acids, gut microbiota, the brain and both enteric and central nervous systems. The understanding of nutrient sensing via enteroendocrine cells, the enteric nervous system, hypothalamic peptides and adipose tissue and of the role of inflammation has advanced our knowledge of this integrative physiology. In this Review, we focus on the adaptation of gut physiology to the anatomical alterations from Roux-en-Y gastric bypass and vertical sleeve gastrectomy and the influence of these procedures on food intake, weight loss, nonalcoholic fatty liver disease (NAFLD) and cancer. We also aim to demonstrate the underlying mechanisms that could explain how metabolic surgery could be used as a therapeutic option in NAFLD and certain obesity-related cancers.

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Authors: Sinclair, P., Brennan, D. J., & le Roux, C. W.
Affiliations: University College Dublin (IE)
ORCID: Sinclair, Piriyah
Brennan, Donal J.
le Roux, Carel W.
Venue: Nature Reviews Gastroenterology & Hepatology
Publisher: Springer Science and Business Media LLC
Published: 2018-09-04
Volume: 15
Issue: 10
Pages: 606-624
ISSN: 1759-5045 (ISSN-L)
1759-5053
DOI: 10.1038/s41575-018-0057-y
OpenAlex: W2890917599
Cited by: 91
References: 249
Citations by year: 2026: 4 · 2025: 10 · 2024: 5 · 2023: 17 · 2022: 16 · 2021: 15 · 2020: 13 · 2019: 11
FWCI: 2.16
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Gastroenterology & Hepatology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords: metabolic surgery, intestinal adaptation, Roux-en-Y gastric bypass, sleeve gastrectomy, gastrointestinal hormones, bile acids, gut microbiota, enteroendocrine cells, enteric nervous system, hypothalamic neuropeptides, adipose tissue, inflammation, satiety, dietary intake, weight loss, non-alcoholic fatty liver disease, obesity-related cancer, glucose metabolism
MeSH terms: Adaptation, Physiological, Animals, Brain, Humans, Liver, Neoplasms, Gastrointestinal Tract, Bariatric Surgery

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Gut adaptation after metabolic surgery and its influences on the brain, liver and cancer

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