Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass
Abstract
In Brief Objective: To evaluate the physiologic importance of the satiety gut hormones. Background: Controversy surrounds the physiologic role of gut hormones in the control of appetite. Bariatric surgery remains the most effective treatment option for obesity, and gut hormones are implicated in the reduction of appetite and weight after Roux-en-Y gastric bypass. Methods: We correlated peptide YY (PYY) and glucagon-like peptide 1 (GLP-1) changes within the first week after gastric bypass with changes in appetite. We also evaluated the gut hormone responses of patients with good or poor weight loss after gastric bypass. Finally, we inhibited the gut hormone responses in gastric bypass patients and then evaluated appetite and food intake. Results: Postprandial PYY and GLP-1 profiles start rising as early as 2 days after gastric bypass (P < 0.05). Changes in appetite are evident within days after gastric bypass surgery (P < 0.05), and unlike other operations, the reduced appetite continues. However, in patients with poor weight loss after gastric bypass associated with increased appetite, the postprandial PYY and GLP-1 responses are attenuated compared with patients with good weight loss (P < 0.05). Inhibiting gut hormone responses, including PYY and GLP-1 after gastric bypass, results in return of appetite and increased food intake (P < 0.05). Conclusion: The attenuated appetite after gastric bypass is associated with elevated PYY and GLP-1 concentrations, and appetite returns when the release of gut hormones is inhibited. The results suggest a role for gut hormones in the mechanism of weight loss after gastric bypass and may have implications for the treatment of obesity. Roux-en-Y gastric bypass is an effective treatment for obesity, and gut hormones have been implicated as causing reduction of appetite and weight. We showed that significant weight loss depends on gut hormone concentrations and that attenuated appetite after gastric bypass is associated with increased gut hormones, and appetite returns when the release of gut hormones is inhibited.
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Gastric bypass subjects have elevated plasma concentrations of GLP-1.
“GB subjects have elevated plasma concentrations of GLP-1 (6,8–13).”
From Gastric Bypass Surgery Enhances Glucagon-Like Peptide 1–Stimulated Postprandial Insulin Secretion in Humans (2011) · cites this paper as [10]
Genetic factors, increases in gut hormones GLP-1 and PYY, and decreases in ghrelin play an important role in appetite regulation and post-surgical weight outcomes.
“Genetic factors [8], increases in gut hormones such as glucagon-like-peptide-1 (GLP-1) and peptide YY (PYY) [9], and decreases in the production of ghrelin play an important role in appetite regulation and post-surgical weight outcomes [10].”
From Patients' Experiences of Weight Regain After Bariatric Surgery (2022) · cites this paper as [9]
Cites
Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery
Sjöström, L., Lindroos, A.-K., Peltonen, M., Torgerson, J., Bouchard, C., Carlsson, B., Dahlgren, S., Larsson, B., Narbro, K., Sjöström, C. D., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa035622 · Cited by 4,457 · see citing works
Ghrelin enhances appetite and increases food intake in humans
Wren, A. M., Seal, L. J., Cohen, M. A., Brynes, A. E., Frost, G. S., Murphy, K. G., Dhillo, W. S., Ghatei, M. A., & Bloom, S. R. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.12.8111 · Cited by 2,494 · see citing works
Gut hormone PYY3-36 physiologically inhibits food intake
Batterham, R. L., Cowley, M. A., Small, C. J., Herzog, H., Cohen, M. A., Dakin, C. L., Wren, A. M., Brynes, A. E., Low, M. J., Ghatei, M. A., et al. (2002) · Nature · doi:10.1038/nature00887 · Cited by 2,351 · see citing works
Pories, W. J., Swanson, M. S., MacDonald, K. G., Long, S. B., Morris, P. G., Brown, B. M., Barakat, H. A., deRamon, R. A., Israel, G., Dolezal, J. M., et al. (1995) · Annals of Surgery · doi:10.1097/00000658-199509000-00011 · Cited by 2,293 · see citing works
Glucagon-like peptide-1 7–36: a physiological incretin in man
Kreymann, B., Ghatei, M. A., Williams, G., & Bloom, S. R. (1987) · The Lancet · doi:10.1016/s0140-6736(87)91194-9 · Cited by 1,928 · see citing works
Inhibition of Food Intake in Obese Subjects by Peptide YY <sub>3–36</sub>
Batterham, R. L., Cohen, M. A., Ellis, S. M., Le Roux, C. W., Withers, D. J., Frost, G. S., Ghatei, M. A., & Bloom, S. R. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa030204 · Cited by 1,604 · see citing works
Anaesthesia, surgery, and challenges in postoperative recovery
Kehlet, H., & Dahl, J. B. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14966-5 · Cited by 1,449 · see citing works
Human distribution and release of a putative new gut hormone, peptide YY
Adrian, T. E., Ferri, G., Bacarese-Hamilton, A. J., Fuessl, H. S., Polak, J. M., & Bloom, S. R. (1985) · Gastroenterology · doi:10.1016/0016-5085(85)90211-2 · Cited by 1,064 · see citing works
Roux, C. W. L., Aylwin, S. J. B., Batterham, R. L., Borg, C. M., Coyle, F., Prasad, V., Shurey, S., Ghatei, M. A., Patel, A. G., & Bloom, S. R. (2006) · Annals of Surgery · doi:10.1097/01.sla.0000183349.16877.84 · Cited by 985 · see citing works
Self-citationWeight Gain After Short- and Long-Limb Gastric Bypass in Patients Followed for Longer Than 10 Years
Christou, N. V., Look, D., & MacLean, L. D. (2006) · Annals of Surgery · doi:10.1097/01.sla.0000217592.04061.d5 · Cited by 727 · see citing works
Attenuated Peptide YY Release in Obese Subjects Is Associated with Reduced Satiety
le Roux, C. W., Batterham, R. L., Aylwin, S. J. B., Patterson, M., Borg, C.-M., Wynne, K., Kent, A. S. H., Vincent, R. P., Gardiner, J., Ghatei, M. A., et al. (2005) · Endocrinology · doi:10.1210/en.2005-0972 · Cited by 549 · see citing works
Energy intake and appetite are suppressed by glucagon-like peptide-1 (GLP-1) in obese men.
Näslund, E., Barkeling, B., King, N., Gutniak, M., Blundell, J., Holst, J., Rössner, S., & Hellström, P. (1999) · International Journal of Obesity · doi:10.1038/sj.ijo.0800818 · Cited by 468 · see citing works
Peptide YY3–36 and Glucagon-Like Peptide-17–36 Inhibit Food Intake Additively
Neary, N. M., Small, C. J., Druce, M. R., Park, A. J., Ellis, S. M., Semjonous, N. M., Dakin, C. L., Filipsson, K., Wang, F., Kent, A. S., et al. (2005) · Endocrinology · doi:10.1210/en.2005-0237 · Cited by 371 · see citing works
Challis, B., Coll, A. P., Yeo, G. S. H., Pinnock, S. B., Dickson, S. L., Thresher, R. R., Dixon, J. B., Zahn, D., Rochford, J. J., White, A. E., et al. (2004) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0306931101 · Cited by 368 · see citing works
Savage, A. P., Adrian, T. E., Carolan‐Rees, G., Chatterjee, K., & Bloom, S. R. (1987) · Gut · doi:10.1136/gut.28.2.166 · Cited by 333 · see citing works
Borg, C.-M., le Roux, C. W., Ghatei, M. A., Bloom, S. R., Patel, A. G., & Aylwin, S. J. B. (2006) · British journal of surgery · doi:10.1002/bjs.5227 · Cited by 318 · see citing works
Distribution and release of human pancreatic polypeptide.
Adrian, T. E., Bloom, S. R., Bryant, M. G., Polak, J. M., Heitz, P., & Barnes, A. (1976) · Gut · doi:10.1136/gut.17.12.940 · Cited by 313 · see citing works
Laparoscopic Roux-en-Y Gastric Bypass: Technique and 3-Year Follow-Up
Higa, K. D., Ho, T., & Boone, K. B. (2001) · Journal of Laparoendoscopic & Advanced Surgical Techniques · doi:10.1089/10926420152761905 · Cited by 287 · see citing works
Peptide YY3–36Inhibits Food Intake in Mice through a Melanocortin-4 Receptor-Independent Mechanism
Halatchev, I. G., Ellacott, K. L. J., Fan, W., & Cone, R. D. (2004) · Endocrinology · doi:10.1210/en.2003-1754 · Cited by 236 · see citing works
Intravenous Infusion of Peptide YY(3–36) Potently Inhibits Food Intake in Rats
Chelikani, P. K., Haver, A. C., & Reidelberger, R. D. (2004) · Endocrinology · doi:10.1210/en.2004-1138 · Cited by 233 · see citing works
Dixon, A. F. R., Dixon, J. B., & O’Brien, P. E. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1546 · Cited by 227 · see citing works
Effects of PYY[3–36] in rodent models of diabetes and obesity
Pittner, R. A., Moore, C. X., Bhavsar, S., Gedulin, B. R., Smith, P. A., Jodka, C. M., Parkes, D. G., Paterniti, J. R., Srivastava, V. P., & Young, A. A. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802696 · Cited by 219 · see citing works
Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass
Kenler, H. A., Brolin, R. E., & Cody, R. (1990) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/52.1.87 · Cited by 201 · see citing works
Characterization of Ghrelin-Like Immunoreactivity in Human Plasma
Patterson, M., Murphy, K. G., le Roux, C. W., Ghatei, M. A., & Bloom, S. R. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1641 · Cited by 177 · see citing works
Peptide YY abnormalities in gastrointestinal diseases
Adrian, T. E., Savage, A. P., Bacarese-Hamilton, A. J., Wolfe, K., Besterman, H. S., & Bloom, S. R. (1986) · Gastroenterology · doi:10.1016/0016-5085(86)90936-4 · Cited by 176 · see citing works
Optimizing Outcomes in Bariatric Surgery
McCarty, T. M., Arnold, D. T., Lamont, J. P., Fisher, T. L., & Kuhn, J. A. (2005) · Annals of Surgery · doi:10.1097/01.sla.0000183354.66073.4c · Cited by 161 · see citing works
Independent influences of body mass and gastric volumes on satiation in humans
Delgado-Aros, S., Cremonini, F., Castillo, J. E., Chial, H. J., Burton, D. D., Ferber, I. J., & Camilleri, M. (2004) · Gastroenterology · doi:10.1053/j.gastro.2003.11.007 · Cited by 160 · see citing works
Riediger, T., Bothe, C., Becskei, C., & Lutz, T. A. (2004) · Neuroendocrinology · doi:10.1159/000079842 · Cited by 119 · see citing works
Release of peptide YY (PYY) after resection of small bowel, colon, or pancreas in man.
Adrian, T. E., Ap, S., Fuessl, H., Wolfe, K., Besterman, H. S., & Bloom, S. R. (1987) · PubMed · Cited by 117 · see citing works
Näslund, E. B., Melin, I., Grybäck, P., Hagg, A., Hellström, P. M., Jacobsson, H., Theodorsson, E., Rössner, S., & Bäckman, L. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/66.1.26 · Cited by 64 · see citing works
Enhancement of feeding suppression by PYY3-36 in rats with area postrema ablations
Cox, J. E., & Randich, A. (2004) · Peptides · doi:10.1016/j.peptides.2004.03.003 · Cited by 58 · see citing works
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Psichas, A., Sleeth, M. L., Murphy, K. G., Brooks, L., Bewick, G. A., Hanyaloglu, A. C., Ghatei, M. A., Bloom, S. R., & Frost, G. (2015) · International Journal of Obesity · doi:10.1038/ijo.2014.153 · Cited by 886 · see citing works
Sjöström, L., Gummesson, A., Sjöström, C. D., Narbro, K., Peltonen, M., Wedel, H., Bengtsson, C., Bouchard, C., Carlsson, B., Dahlgren, S., et al. (2009) · The Lancet Oncology · doi:10.1016/s1470-2045(09)70159-7 · Cited by 770 · see citing works
Self-citationObesity and the human microbiome
Ley, R. E. (2009) · Current Opinion in Gastroenterology · doi:10.1097/mog.0b013e328333d751 · Cited by 768 · see citing works
Steinert, R. E., Feinle-Bisset, C., Asarian, L., Horowitz, M., Beglinger, C., & Geary, N. (2017) · Physiological Reviews · doi:10.1152/physrev.00031.2014 · Cited by 578 · see citing works
Peterli, R., Wölnerhanssen, B. K., Peters, T. T. A., Devaux, N., Kern, B. E., Christoffel-Courtin, C., Drewe, J., von Flüe, M., & Beglinger, C. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e3181ae32e3 · Cited by 565 · see citing works
Heber, D., Greenway, F. L., Kaplan, L. M., Livingston, E., Salvador, J., & Still, C. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2128 · Cited by 521 · see citing works
Graessler, J., Qin, Y., Zhong, H., Zhang, J., Licinio, J., Wong, M.-L., Xu, A., Chavakis, T., Bornstein, A. B., Ehrhart-Bornstein, M., et al. (2013) · The Pharmacogenomics Journal · doi:10.1038/tpj.2012.43 · Cited by 428 · see citing works
Physiological adaptations to weight loss and factors favouring weight regain
Greenway, F. L. (2015) · International Journal of Obesity · doi:10.1038/ijo.2015.59 · Cited by 431 · see citing works
Pournaras, D. J., Glicksman, C., Vincent, R. P., Kuganolipava, S., Alaghband-Zadeh, J., Mahon, D., Bekker, J. H. R., Ghatei, M. A., Bloom, S. R., Walters, J. R. F., et al. (2012) · Endocrinology · doi:10.1210/en.2011-2145 · Cited by 383 · see citing works
Brain Regulation of Appetite and Satiety
Ahima, R. S., & Antwi, D. A. (2008) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2008.08.005 · Cited by 387 · see citing works
Metabolic Surgery to Treat Type 2 Diabetes: Clinical Outcomes and Mechanisms of Action
Rubino, F., Schauer, P. R., Kaplan, L. M., & Cummings, D. E. (2010) · Annual Review of Medicine · doi:10.1146/annurev.med.051308.105148 · Cited by 383 · see citing works
“Vitamin B12 and folate deficiency can be as high as 33% and 63%, respectively (54).”
BackgroundGut Hormones and Appetite Control: A Focus on PYY and GLP-1 as Therapeutic Targets in Obesity
Silva, A. D., & Bloom, S. R. (2012) · Gut and Liver · doi:10.5009/gnl.2012.6.1.10 · Cited by 373 · see citing works
“Significantly, inhibiting the PYY and GLP-1 responses results in return of appetite and increases food intake.(29) Therefore, it is likely that elevated levels of PYY and GLP-1 play a key role in the sustained weight loss observed following gastric bypass surgery.”
BackgroundSelf-citationJacobsen, S. H., Olesen, S. C., Dirksen, C., Jørgensen, N. B., Bojsen-Møller, K. N., Kielgast, U., Worm, D., Almdal, T., Naver, L. S., Hvolris, L. E., et al. (2012) · Obesity Surgery · doi:10.1007/s11695-012-0621-4 · Cited by 342 · see citing works
“intestinal hormone responses, insulin sensitivity, and betacell function during the first 1 to 2 weeks after surgery [7–12].”
BackgroundResultKorner, J., Inabnet, W., Febres, G., Conwell, I. M., McMahon, D. J., Salas, R., Taveras, C., Schrope, B., & Bessler, M. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.79 · Cited by 338 · see citing works
“Although these associations do not prove causality, inhibition of gut hormone release by administration of somatostatin increased appetite and food intake in bypass but not in band subjects, suggesting that gut hormones are more likely to mediate reduced appetite and food intake after RYGB (24).”
BackgroundResultSatiation, satiety and their effects on eating behaviour
Benelam, B. (2009) · Nutrition Bulletin · doi:10.1111/j.1467-3010.2009.01753.x · Cited by 338 · see citing works
Poirier, P., Cornier, M.-A., Mazzone, T., Stiles, S., Cummings, S., Klein, S., McCullough, P. A., Ren Fielding, C., & Franklin, B. A. (2011) · Circulation · doi:10.1161/cir.0b013e3182149099 · Cited by 339 · see citing works
Salehi, M., Prigeon, R. L., & D’Alessio, D. A. (2011) · Diabetes · doi:10.2337/db11-0203 · Cited by 323 · see citing works
Rubino, F., Kaplan, L. M., Schauer, P. R., & Cummings, D. E. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181be34e7 · Cited by 325 · see citing works
The role of gut hormones and the hypothalamus in appetite regulation
Suzuki, K., Simpson, K. A., MINNION, J. S., Shillito, J. C., & Bloom, S. R. (2010) · Endocrine Journal · doi:10.1507/endocrj.k10e-077 · Cited by 318 · see citing works
“For example, a decrease in circulating ghrelin and an increase in peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) levels have been found following bypass surgery [15-17].”
BackgroundFalkén, Y., Hellström, P. M., Holst, J. J., & Näslund, E. B. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2876 · Cited by 315 · see citing works
International consensus on the diagnosis and management of dumping syndrome
Scarpellini, E., Arts, J., Karamanolis, G., Laurenius, A., Siquini, W., Suzuki, H., Ukleja, A., van Beek, A. V., Vanuytsel, T., Bor, S., et al. (2020) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-0357-5 · Cited by 247 · see citing works
Schiavon, C. A., Bersch-Ferreira, A. C., Santucci, E. V., Oliveira, J. D., Torreglosa, C. R., Bueno, P. T., Frayha, J. C., Santos, R. N., Damiani, L. P., Noujaim, P. M., et al. (2018) · Circulation · doi:10.1161/circulationaha.117.032130 · Cited by 308 · see citing works
Troy, S., Soty, M., Ribeiro‐Parenti, L., Laval, L., Migrenne, S., Fioramonti, X., Pillot, B., Fauveau, V., Aubert, R., Viollet, B., et al. (2008) · Cell Metabolism · doi:10.1016/j.cmet.2008.08.008 · Cited by 302 · see citing works
“However, recent observations were in disagreement with this hypothesis (Korner et al., 2005; le Roux et al., 2007; Reinehr et al., 2007).”
BackgroundResultBariatric surgery for type 2 diabetes
Dixon, J. B., le Roux, C. W., Rubino, F., & Zimmet, P. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60401-2 · Cited by 295 · see citing works
Wilson, H., Chambers, A. P., Ryan, K. K., Li, B., Sandoval, D. A., Stoffers, D. A., Drucker, D. J., Pérez–Tilve, D., & Seeley, R. J. (2013) · Diabetes · doi:10.2337/db12-1498 · Cited by 292 · see citing works
“For example, one 2007 study showed that meal-induced GLP-1 (and peptide YY [PYY]) excursions are higher in RYGB patients with superior weight loss compared with those who did not achieve sufficient weight loss (16).”
BackgroundRegulation of Glucose Homeostasis by GLP-1
Nadkarni, P., Chepurny, O. G., & Holz, G. G. (2014) · Progress in Molecular Biology and Translational Science · doi:10.1016/b978-0-12-800101-1.00002-8 · Cited by 287 · see citing works
Kehagias, I., Karamanakos, S. N., Argentou, M., & Kalfarentzos, F. (2011) · Obesity Surgery · doi:10.1007/s11695-011-0479-x · Cited by 349 · see citing works
“Delivery to the jejunum of undigested chime of higher pH could enhance PYY and GLP-1 response to the meal, inducing satiety [24, 41, 42].”
BackgroundInfluentialDirksen, C., Jørgensen, N. B., Bojsen-Møller, K. N., Kielgast, U., Jacobsen, S. H., Clausen, T. R., Worm, D., Hartmann, B., Rehfeld, J. F., Damgaard, M., et al. (2013) · International Journal of Obesity · doi:10.1038/ijo.2013.15 · Cited by 276 · see citing works
Marsk, R., Jonas, E., Rasmussen, F., & Näslund, E. (2010) · Diabetologia · doi:10.1007/s00125-010-1798-5 · Cited by 273 · see citing works
“One mechanism postulated to improve diabetes after gastric bypass is an augmented incretin response; postprandial plasma concentrations of the potent incretin glucagon-like peptide-1 rise after gastric bypass [2].”
BackgroundCurrent treatments for obesity
Ruban, A., Stoenchev, K. V., Ashrafian, H., & TEARE, J. P. (2019) · Clinical Medicine · doi:10.7861/clinmedicine.19-3-205 · Cited by 267 · see citing works
Ribaric, G., Buchwald, J. N., & McGlennon, T. W. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1160-3 · Cited by 267 · see citing works
The importance of the gut microbiota after bariatric surgery
Aron‐Wisnewsky, J., Dore, J. M., & Clément, K. (2012) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2012.161 · Cited by 259 · see citing works
Brain–gut–microbiome interactions in obesity and food addiction
Gupta, A., Osadchiy, V., & Mayer, E. A. (2020) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-020-0341-5 · Cited by 268 · see citing works
Kokkinos, A. D., le Roux, C. W., Αλεξιάδου, Κ., Tentolouris, N., Vincent, R. P., Kyriaki, D., Perrea, D. N., Ghatei, M. A., Bloom, S. R., & Katsilambros, N. L. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1018 · Cited by 254 · see citing works
“In the case of the postprandial increase in PYY and GLP-1 levels and decrease in ghrelin, previous studies have consistently shown that these can be accurately assessed by sampling protocols similar to ours (9).”
BackgroundResultIsbell, J. M., Tamboli, R. A., Hansen, E. N., Saliba, J., Dunn, J. P., Phillips, S. E., Marks–Shulman, P. A., & Abumrad, N. N. (2010) · Diabetes Care · doi:10.2337/dc09-2107 · Cited by 248 · see citing works
Gastric bypass reduces fat intake and preference
le Roux, C. W., Bueter, M., Theis, N., Werling, M., Ashrafian, H., Löwenstein, C., Athanasiou, T., Bloom, S. R., Spector, A. C., Olbers, T., et al. (2011) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00139.2011 · Cited by 240 · see citing works
Seeley, R., Chambers, A. P., & Sandoval, D. (2015) · Cell Metabolism · doi:10.1016/j.cmet.2015.01.001 · Cited by 218 · see citing works
“Consistent with this hypothesis, post-surgical increases in prandial GLP-1 are associated with greater insulin release (Umeda et al., 2011) and greater weight loss (le Roux et al., 2007) after RYGB surgery in humans.”
ResultSuzuki, K., Jayasena, C. N., & Bloom, S. R. (2012) · Experimental Diabetes Research · doi:10.1155/2012/824305 · Cited by 227 · see citing works
Remission of Type 2 Diabetes After Gastric Bypass and Banding
Pournaras, D. J., Osborne, A., Hawkins, S. C., Vincent, R. P., Mahon, D., Ewings, P., Ghatei, M. A., Bloom, S. R., Welbourn, R., & le Roux, C. W. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181efc49a · Cited by 226 · see citing works
Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different
Pucci, A. B. F., & Batterham, R. L. (2018) · Journal of Endocrinological Investigation · doi:10.1007/s40618-018-0892-2 · Cited by 222 · see citing works
“This hypothesis is supported by three lines of evidence: first, the administration of the somatostatin analogue octreotide to people following RYGB leads to increased appetite and energy intake, and weight gain [66]; second, combined administration of di-peptidyl peptidase inhibitor (DPP4) inhibitor and exendin 9-39 (…”
MethodAppetite regulation and weight control: the role of gut hormones
Perry, B., & Wang, Y. (2012) · Nutrition and Diabetes · doi:10.1038/nutd.2011.21 · Cited by 216 · see citing works
Peripheral Mechanisms in Appetite Regulation
Camilleri, M. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.09.016 · Cited by 215 · see citing works
Stubbs, J., Whybrow, S., Teixeira, P., Blundell, J., Lawton, C., Westenhoefer, J., Engel, D., Shepherd, R., McConnon, A., Gilbert, P., et al. (2011) · Obesity Reviews · doi:10.1111/j.1467-789x.2011.00883.x · Cited by 211 · see citing works
“They suggested that gut hormones have a role to play in the mechanism of weight loss after gastric bypass, through their effects on appetite (38).”
BackgroundGastric Bypass Increases Energy Expenditure in Rats
Bueter, M., Löwenstein, C., Olbers, T., Wang, M., Cluny, N. L., Bloom, S. R., Sharkey, K. A., Lutz, T. A., & le Roux, C. W. (2009) · Gastroenterology · doi:10.1053/j.gastro.2009.11.012 · Cited by 206 · see citing works
Gut Microbiome and Obesity: A Plausible Explanation for Obesity
Sanmiguel, C. P., Gupta, A., & Mayer, E. A. (2015) · Current Obesity Reports · doi:10.1007/s13679-015-0152-0 · Cited by 203 · see citing works
Mechanisms in bariatric surgery: Gut hormones, diabetes resolution, and weight loss
Holst, J. J., Madsbad, S., Bojsen-Møller, K. N., Svane, M. S., Jørgensen, N. B., Dirksen, C., & Martinussen, C. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.03.003 · Cited by 203 · see citing works
Changes in Gastrointestinal Hormones and Leptin after Roux-en-Y Gastric Bypass Procedure: A Review
Beckman, L. M., Beckman, T. R., & Earthman, C. P. (2010) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2009.12.023 · Cited by 196 · see citing works
“Continued 578 April2010 Volum e 110 Num ber 4 Hormones measured Limb length Study groups Time points Measurements Summary Ghrelin, PYY, GLP-1 (49) Not reported Group 1: RYGB (n"8, 8 F); Group 2: GB (n"6, 6 F); Group 3: nonoperated weight matched to post-op RYGB and GB (n"8, 8 F) Post-op only (RYGB: 9 to 48 mo post-op;…”
BackgroundResultInfluentialMiras, A. D., Pérez-Pevida, B., Aldhwayan, M., Kamocka, A., McGlone, E. R., Al-Najim, W., Chahal, H., Batterham, R. L., McGowan, B., Khan, O., et al. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30157-3 · Cited by 190 · see citing works
Narrative Review: Effect of Bariatric Surgery on Type 2 Diabetes Mellitus
Vetter, M. L., Cardillo, S., Rickels, M. R., & Iqbal, N. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-2-200901200-00007 · Cited by 192 · see citing works
“le Roux and colleagues (70) reported that postprandial PYY and GLP-1 levels increased as early as 2 days after RYGB.”
BackgroundCausality of small and large intestinal microbiota in weight regulation and insulin resistance
Scheithauer, T. P. M., Dallinga-Thie, G. M., de Vos, W. M., Nieuwdorp, M., & van Raalte, D. H. (2016) · Molecular Metabolism · doi:10.1016/j.molmet.2016.06.002 · Cited by 188 · see citing works
“Bariatric surgery was associated with increased PYY and GLP-1 levels post surgery, explaining, to some degree, the weight reduction due to higher satiety signals [149].”
BackgroundGLP-1: Molecular mechanisms and outcomes of a complex signaling system
Smith, N. K., Hackett, T. A., Galli, A., & Flynn, C. R. (2019) · Neurochemistry International · doi:10.1016/j.neuint.2019.04.010 · Cited by 199 · see citing works
Incretin hormones and the satiation signal
Holst, J. J. (2013) · International Journal of Obesity · doi:10.1038/ijo.2012.208 · Cited by 189 · see citing works
Gibbons, C., Caudwell, P., Finlayson, G., Webb, D., Hellström, P. M., Näslund, E. B., & Blundell, J. E. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-3835 · Cited by 186 · see citing works
Svane, M. S., Jørgensen, N. B., Bojsen-Møller, K. N., Dirksen, C., Nielsen, S., Kristiansen, V. B., Toräng, S., Wewer Albrechtsen, N. J., Rehfeld, J. F., Hartmann, B., et al. (2016) · International Journal of Obesity · doi:10.1038/ijo.2016.121 · Cited by 185 · see citing works
Ding, L., Sousa, K. M., Jin, L., Dong, B., Kim, B., Ramírez, R., Xiao, Z., Gu, Y., Yang, Q., Wang, J., et al. (2016) · Hepatology · doi:10.1002/hep.28689 · Cited by 180 · see citing works
“GLP-1 is a powerful hormone whose ability to stimulate insulin secretion and normalize glucose levels has been widely documented, and GLP-1 levels increase after bariatric surgery.((20,44,45)) Surprisingly, it has been reported that the GLP-1 receptor is not required for DING ET AL.”
BackgroundSignalling from the periphery to the brain that regulates energy homeostasis
Kim, K., Seeley, R. J., & Sandoval, D. A. (2018) · Nature reviews. Neuroscience · doi:10.1038/nrn.2018.8 · Cited by 183 · see citing works
Mok, J., Adeleke, M. O., Brown, A., Magee, C. G., Firman, C., Makahamadze, C., Jassil, F. C., Marvasti, P., Carnemolla, A., Devalia, K., et al. (2023) · JAMA Surgery · doi:10.1001/jamasurg.2023.2930 · Cited by 178 · see citing works
le Roux, C. W., Borg, C., Wallis, K., Vincent, R. P., Bueter, M., Goodlad, R., Ghatei, M. A., Patel, A., Bloom, S. R., & Aylwin, S. J. B. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181d3d21f · Cited by 176 · see citing works
“Suppression of the release of gut hormones such as PYY and GLP-1 with the somatostatin analogue octreotide after RYGB reverses the enhanced satiety and increases food intake acutely.(39) Although there may be additional satiety factors that contribute to reduced food intake after RYGB, taken together, these observatio…”
BackgroundSelf-citationFood Intake and Eating Behavior After Bariatric Surgery
Al‐Najim, W., Docherty, N. G., & le Roux, C. W. (2018) · Physiological Reviews · doi:10.1152/physrev.00021.2017 · Cited by 179 · see citing works
Laursen, T. L., Hagemann, C. A., Wei, C., Kazankov, K., Thomsen, K. L., Knop, F. K., & Grønbæk, H. (2019) · World Journal of Hepatology · doi:10.4254/wjh.v11.i2.138 · Cited by 176 · see citing works
Changes in Eating Behaviour and Meal Pattern Following Roux-En-Y Gastric Bypass
Laurenius, A., Larsson, I., Bueter, M., Melanson, K. J., Bosaeus, I., Forslund, H. B., Lönroth, H., Fändriks, L., & Olbers, T. (2012) · International Journal of Obesity · doi:10.1038/ijo.2011.217 · Cited by 174 · see citing works
Intestinal Microbiota During Infancy and Its Implications for Obesity
Reinhardt, C., Reigstad, C. S., & Bäckhed, F. (2009) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e318183187c · Cited by 173 · see citing works
“It is possible that RYGP leads to an altered microbial composition that regulates enteroendocrine function.”
BackgroundInfluentialMokadem, M., Zechner, J. F., Margolskee, R. F., Drucker, D. J., & Aguirre, V. (2013) · Molecular Metabolism · doi:10.1016/j.molmet.2013.11.010 · Cited by 174 · see citing works
“Third, administration of octreotide to patients after RYGB inhibits the secretion of GLP-1 (and other gut hormones), and also decreases satiety and increases food intake [5].”
BackgroundGLP-1 receptor signaling is not required for reduced body weight after RYGB in rodents
Ye, J., Hao, Z., Mumphrey, M. B., Townsend, R. L., Patterson, L. M., Stylopoulos, N., Münzberg, H., Morrison, C. D., Drucker, D. J., & Berthoud, H. (2014) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00491.2013 · Cited by 174 · see citing works
Alterations of sucrose preference after Roux-en-Y gastric bypass
Bueter, M., Miras, A. D., Chichger, H., Fenske, W. K., Ghatei, M. A., Bloom, S. R., Unwin, R. J., Lutz, T. A., Spector, A. C., & le Roux, C. W. (2011) · Physiology & Behavior · doi:10.1016/j.physbeh.2011.07.025 · Cited by 173 · see citing works
“37 confirmed that gastric bypass in rats, as in humans, leads to increased postprandial levels of GLP-1 and PYY [42,43].”
InfluentialMetabolic surgery: the role of the gastrointestinal tract in diabetes mellitus
Rubino, F., R'bibo, S. L., del Genio, F., Mazumdar, M., & McGraw, T. E. (2010) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.268 · Cited by 173 · see citing works
Bowels control brain: gut hormones and obesity
Field, B. C. T., Chaudhri, O. B., & Bloom, S. R. (2010) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2010.93 · Cited by 171 · see citing works
“48 Rodent studies also provide evidence of an anorectic synergy when IAPP is coadministered with either PYY(3-36) or cholecystokinin (CCK).”
The role of the gut/brain axis in modulating food intake
Sam, A. H., Troke, R., Tan, T., & Bewick, G. A. (2011) · Neuropharmacology · doi:10.1016/j.neuropharm.2011.10.008 · Cited by 168 · see citing works
“Post-prandial PYY and GLP-1 levels begin to rise as early as 2 days following gastric bypass in humans (le Roux et al., 2007), and secretory products of enteroendocrine L cells, including PYYandGLP1 remainelevated twoyears after bypass surgery (leRouxet al., 2010).”
BackgroundMeal patterns, satiety, and food choice in a rat model of Roux-en-Y gastric bypass surgery
Zheng, H., Shin, A. C., Lenard, N. R., Townsend, R. L., Patterson, L. M., Sigalet, D. L., & Berthoud, H. (2009) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00343.2009 · Cited by 165 · see citing works
“mones such as PYY, GLP-1, and amylin, and/or enhanced meal-induced suppression of ghrelin secretion, in a caloriedependent manner (15, 16, 21, 22).”
BackgroundGastrointestinal hormones and bariatric surgery-induced weight loss
Ionut, V., Burch, M. A., Youdim, A., & Bergman, R. N. (2013) · Obesity · doi:10.1002/oby.20364 · Cited by 162 · see citing works
“Blockade of gut hormone release with somatostatin during a meal increased food intake in a the GB group but not in a weight loss matched gastric banding group, suggesting that the GLP-1 response contributes to changes in food intake in the GB group, but not in the banding group (24).”
BackgroundInfluentialMechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review
Abdeen, G., & le Roux, C. (2016) · Obesity Surgery · doi:10.1007/s11695-015-1945-7 · Cited by 162 · see citing works
“peripheral effects on glycaemia and food intake [52, 75, 204] has given new insight into the physiological changes that take”
BackgroundCampos, G. M., Rabl, C., Peeva, S., Ciovica, R., Rao, M. N., Schwarz, J., Havel, P. J., Schambelan, M., & Mulligan, K. M. (2009) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-009-1060-y · Cited by 160 · see citing works
Clinical relevance of the bile acid receptor TGR5 in metabolism
van Nierop, F. S., Scheltema, M. J. V., Eggink, H. M., Pols, T. W. H., Sonne, D. P., Knop, F. K., & Soeters, M. R. (2016) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(16)30155-3 · Cited by 158 · see citing works
Søvik, T. T., Taha, O., Aasheim, E. T., Engström, M., Kristinsson, J., Björkman, S., Schou, C. F., Lönroth, H., Mala, T., & Olbers, T. (2010) · Journal of British Surgery · doi:10.1002/bjs.6802 · Cited by 155 · see citing works
Molecular mechanisms underlying nutrient-stimulated incretin secretion
Parker, H. E., Reimann, F., & Gribble, F. M. (2010) · Expert Reviews in Molecular Medicine · doi:10.1017/s146239940900132x · Cited by 155 · see citing works
Increased Risk of Colorectal Cancer After Obesity Surgery
Derogar, M., Hull, M. A., Kant, P., Östlund, M. P., Lu, Y., & Lagergren, J. (2013) · Annals of Surgery · doi:10.1097/sla.0b013e318288463a · Cited by 155 · see citing works
Crosstalk between glucagon-like peptide 1 and gut microbiota in metabolic diseases
Zeng, Y., Wu, Y., Zhang, Q., & Xiao, X. (2023) · mBio · doi:10.1128/mbio.02032-23 · Cited by 166 · see citing works
Mechanisms of weight loss and improved metabolism following bariatric surgery
Mulla, C. M., Middelbeek, R. J. W., & Patti, M. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13409 · Cited by 152 · see citing works
Shin, A. C., Zheng, H., & Berthoud, H. (2009) · Physiology & Behavior · doi:10.1016/j.physbeh.2009.02.010 · Cited by 148 · see citing works
“This lower gut hormone has now been convincingly demonstrated to suppress food intake in humans and rodents [130, 131] and is thought to be important for decreased food intake after Roux-en-Y gastric bypass surgery [132,133].”
Meal-Induced Hormone Responses in a Rat Model of Roux-en-Y Gastric Bypass Surgery
Shin, A. C., Zheng, H., Townsend, R. L., Sigalet, D. L., & Berthoud, H. (2010) · Endocrinology · doi:10.1210/en.2009-1332 · Cited by 150 · see citing works
“fusion resulted in larger meals taken by RYGB patients (6).”
BackgroundBile acids and bariatric surgery
Albaugh, V. L., Banan, B., Ajouz, H., Abumrad, N. N., & Flynn, C. R. (2017) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2017.04.001 · Cited by 148 · see citing works
“We (Isbell et al., 2010) and others (Kashyap et al., 2010; Laferr ere et al., 2007; le Roux et al., 2007; Morínigo et al., 2006a) have described large increases in postprandial GLP-1 immediately after RYGB that are sustained in the long-term (Bose et al., 2010; Morínigo et al., 2006a, 2006b; Vidal…”
BackgroundWeight Regain After Gastric Bypass: Influence of Gut Hormones
Santo, M. A., Riccioppo, D., Pajecki, D., Kawamoto, F., de Cleva, R., Antonangelo, L., Marçal, L., & Cecconello, I. (2016) · Obesity Surgery · doi:10.1007/s11695-015-1908-z · Cited by 145 · see citing works
“early after surgery and is mediated by gastrointestinal hormones [14], which influence hunger and energy balance by regulating the intake, storage, and energy expenditure”
BackgroundResultWharton, S., Kuk, J. L., Luszczynski, M., Kamran, E., & Christensen, R. A. G. (2019) · Clinical Obesity · doi:10.1111/cob.12323 · Cited by 144 · see citing works
“Surgeries that remove a portion of the stomach (eg, RNYGB and gastric sleeve) are associated with increase in glucagon-like peptide-1 (GLP-1) levels, which have been thought to in part contribute to sustained weight loss post-surgery.(15,16) Despite these well-known differences due to the type of bariatric surgery, fe…”
BackgroundSimonen, M., Dali-Youcef, N., Kaminska, D., Venesmaa, S., Käkelä, P., Pääkkönen, M., Hallikainen, M., Kolehmainen, M., Uusitupa, M., Moilanen, L., et al. (2012) · Obesity Surgery · doi:10.1007/s11695-012-0673-5 · Cited by 145 · see citing works
“The most common explanation for the more effective improvement in blood glucose levels after RYGB is altered secretion of gastrointestinal hormones, including GLP-1 and GIP, which stimulate insulin secretion [5–8].”
BackgroundNeff, K., Olbers, T., & le Roux, C. W. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-8 · Cited by 144 · see citing works
Roles of the gut in the metabolic syndrome: an overview
Fändriks, L. (2016) · Journal of Internal Medicine · doi:10.1111/joim.12584 · Cited by 142 · see citing works
Olbers, T., Gronowitz, E., Werling, M., Marlid, S., Flodmark, C., Peltonen, M., Gothberg, G., Karlsson, J., Ekbom, K., Sjöström, L., et al. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.160 · Cited by 142 · see citing works
Penney, N. C., Kinross, J. K., Newton, R. C., & Purkayastha, S. (2015) · International Journal of Obesity · doi:10.1038/ijo.2015.115 · Cited by 140 · see citing works
Gut hormones: Implications for the treatment of obesity
Neary, M. T., & Batterham, R. L. (2009) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2009.06.005 · Cited by 138 · see citing works
Changes in neurohormonal gut peptides following bariatric surgery
Ochner, C. N., Gibson, C. D., Shanik, M. H., Goel, V., & Geliebter, A. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.132 · Cited by 135 · see citing works
Bose, M., Oliván, B., Teixeira, J., Pi-Sunyer, X., & Laferrère, B. (2008) · Obesity Surgery · doi:10.1007/s11695-008-9696-3 · Cited by 130 · see citing works
“The GLP-1 increase occurs as early as 2 days after GBP [71] and persists at 6 months and 1 year [72].”
BackgroundThe future role of gut hormones in the treatment of obesity
Troke, R., Tan, T., & Bloom, S. R. (2013) · Therapeutic Advances in Chronic Disease · doi:10.1177/2040622313506730 · Cited by 126 · see citing works
Longitudinal changes in pancreatic and adipocyte hormones following Roux-en-Y gastric bypass surgery
Swarbrick, M. M., Stanhope, K. L., Austrheim-Smith, I. T., Loan, M. D. V., Ali, M. R., Wolfe, B. M., & Havel, P. J. (2008) · Diabetologia · doi:10.1007/s00125-008-1118-5 · Cited by 125 · see citing works
“For example, postprandial GLP-1 levels increase as early as 2 days after RYGBP [26]; and in addition to its potential effects to stimulate insulin secretion, GLP-1 has actions to suppress endogenous glucose production, promote glucose uptake, and importantly, to reduce glucagon secretion [27].”
BackgroundThe role of gut hormone peptide YY in energy and glucose homeostasis: Twelve years on
Manning, S., & Batterham, R. L. (2014) · Annual Review of Physiology · doi:10.1146/annurev-physiol-021113-170404 · Cited by 124 · see citing works
Alterations in Gut Hormones After Laparoscopic Sleeve Gastrectomy
Dimitriadis, E., Daskalakis, M., Kampa, M., Peppe, A., Papadakis, J. A., & Melissas, J. (2012) · Annals of Surgery · doi:10.1097/sla.0b013e31826e1846 · Cited by 123 · see citing works
Modulation of taste responsiveness and food preference by obesity and weight loss
Berthoud, H.-R., & Zheng, H. (2012) · Physiology & Behavior · doi:10.1016/j.physbeh.2012.04.004 · Cited by 123 · see citing works
“For example, circulating levels of both insulin and the lower gut hormone GLP-1 are affected by obesity [69], and both have been shown to modulate reward functions [70,71].”
GLP-1 physiology in obesity and development of incretin-based drugs for chronic weight management
Holst, J. J. (2024) · Nature Metabolism · doi:10.1038/s42255-024-01113-9 · Cited by 125 · see citing works
“During somatostatin infusion, there is also a significant increase in food intake, supporting the effects of the gut hormones 100,101 .”
Goldstone, A. P., Miras, A. D., Scholtz, S., Jackson, S., Neff, K. J., Pénicaud, L., Geoghegan, J., Chhina, N., Durighel, G., Bell, J. D., et al. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-2665 · Cited by 121 · see citing works
Phillips, L. K., & Prins, J. B. (2011) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2012.06491.x · Cited by 120 · see citing works
The Effect of Bariatric Surgery on Intestinal Absorption and Transit Time
Carswell, K. A., Vincent, R. P., Belgaumkar, A. P., Sherwood, R. A., Amiel, S. A., Patel, A. G., & le Roux, C. W. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1166-x · Cited by 119 · see citing works
“Interestingly, these rises in post-prandial GLP-1 and PYY secretion have been shown to increase further over the first 6 months post-RYGB [61, 88].”
Background
- Authors
- le Roux, C. W., Welbourn, R., Werling, M., Osborne, A., Kokkinos, A., Laurenius, A., Lönroth, H., Fändriks, L., Ghatei, M. A., Bloom, S. R., & Olbers, T.
- Affiliations
- Musgrove Park Hospital (GB)
- Sahlgrenska University Hospital (SE)
- Hammersmith Hospital (GB)
- Corresponding author
- Kokkinos, Alexander
- Ghatei, Mohammad A.
- Bloom, Stephen R.
- ORCID
- Venue
- Annals of Surgery
- Published
- 2007-11
- Volume
- 246
- Issue
- 5
- Pages
- 780-785
- ISSN
- 0003-4932 (ISSN-L)
- OpenAlex
- W2079737026
- Cited by
- 741
- References
- 31
- Citations by year
- 2026: 20 · 2025: 20 · 2024: 28 · 2023: 25 · 2022: 28 · 2021: 49 · 2020: 36 · 2019: 38 · 2018: 35 · 2017: 38 · 2016: 53 · 2015: 61 · 2014: 49 · 2013: 45 · 2012: 63
- FWCI
- 34.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (DHCS/05/05)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- gastrointestinal hormones, appetite regulation, Roux-en-Y gastric bypass, peptide YY, glucagon-like peptide-1, satiety, weight loss, obesity, postprandial hormone response, dietary intake, bariatric surgery
- MeSH terms
- Appetite Regulation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Prospective Studies, Gastric Bypass, Weight Loss, Body Mass Index, Treatment Outcome, Peptide YY, Glucagon-Like Peptide 1, Ghrelin
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