Effects of Roux-en-Y Gastric Bypass Surgery on Fasting and Postprandial Concentrations of Plasma Ghrelin, Peptide YY, and Insulin
Abstract
To help understand the mechanisms by which weight loss is maintained after Roux-en-Y gastric bypass (RYGBP), we measured circulating concentrations of total and bioactive octanoylated ghrelin, peptide YY (PYY), glucose, and insulin in the fasted state and in response to a liquid test meal in three groups of adult women: lean (n = 8); weight-stable 35 +/- 5 months after RYGBP (n = 12; mean body mass index, 33 kg/m(2)); and matched to the surgical group for body mass index and age (n = 12). Fasting plasma total ghrelin levels were nearly identical between RYGBP (425 +/- 54 pg/ml) and the matched controls (424 +/- 28 pg/ml) and highest in lean controls (564 +/- 103 pg/ml). The response to the test meal was comparable between lean and RYGBP groups, with 27% and 20% maximal suppression, respectively, whereas the magnitude of suppression was significantly diminished in the matched controls (17%) compared with the lean group. Fasting levels of octanoylated ghrelin were highest in the lean controls, 220 +/- 36 pg/ml vs. 143 +/- 27 in the RYGBP group (P = 0.05) and 127 +/- 12 pg/ml in the matched controls (P < 0.05). The magnitude of maximal postmeal suppression of octanoylated ghrelin was more marked than with total ghrelin, but similar among groups, ranging from 44-47%. In response to the test meal, there was an early exaggerated rise in PYY in the RYGBP group, such that the peak PYY concentration was 163 +/- 24 pg/ml compared with 58 +/- 17 (P < 0.01) and 77 +/- 23 (P < 0.05) in the matched and lean controls, respectively; area under the curve at 90 min was significantly greater compared with both control groups. Leptin and fasting insulin concentrations and homeostasis model of assessment insulin resistance indices were nearly identical between lean and RYGBP subjects and significantly higher in the body mass index-matched controls. In summary, the absence of a compensatory increase in ghrelin concentrations that usually occurs with diet-induced weight loss, and the exaggerated postprandial PYY response after RYGBP, may contribute to weight loss and to the ability of an individual to maintain weight loss after this surgical procedure.
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The liquid meal challenge used does not elicit dumping syndrome or abdominal discomfort in post-surgery patients.
“The choice of the meal challenge was based on our previous studies demonstrating that the macronutrient content and volume load does not illicit dumping syndrome or abdominal discomfort in post-surgery patients (11, 13).”
From Prospective study of gut hormone and metabolic changes after adjustable gastric banding and Roux-en-Y gastric bypass (2009) · cites this paper as [13]
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- Authors
- Korner, J., Bessler, M., Cirilo, L. J., Conwell, I. M., Daud, A., Restuccia, N. L., & Wardlaw, S. L.
- Affiliations
- Columbia University (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-01
- Volume
- 90
- Issue
- 1
- Pages
- 359-365
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2159048625
- Cited by
- 417
- References
- 51
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 9 · 2021: 15 · 2020: 9 · 2019: 8 · 2018: 11 · 2017: 22 · 2016: 17 · 2015: 15 · 2014: 21 · 2013: 26 · 2012: 35
- FWCI
- 39.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (RR-00645)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK59316, R01DK057561, DK-57561, K08DK059316)
- National Center for Research Resources (RR 00645, M01RR000645)
- 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
- Roux-en-Y gastric bypass, ghrelin, peptide YY, insulin, postprandial hormone response, weight loss maintenance, leptin, insulin resistance, bariatric surgery, appetite regulation, glycemic response, obese women, leptin resistance
- MeSH terms
- Adult, Anastomosis, Roux-en-Y, Appetite, Blood Glucose, Fasting, Female, Humans, Insulin, Pain Measurement, Gastric Bypass, Weight Loss, Peptide YY, Leptin, Peptide Hormones, Ghrelin
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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