Review Article

Role of Gut-Related Peptides and Other Hormones in the Amelioration of Type 2 Diabetes after Roux-en-Y Gastric Bypass Surgery

Table 2

GLP-1 and RYGB surgery.

Author/yearType of studySubjectsPreop BMI% weight lossF/U timeChange in hormone

Morínigo et al. 2006 [51]Prospective controlled9 (7 F) RYGB non diabetic
6 obese (4 F)
4 7 . 4 ± 6 . 1
4 3 . 6 ± 7 . 9
NA6 wkGreater increase in active GLP-1 postmeal in RYGB group postop compared to weight-matched obese
Laferrère et al. 2007 [50]Prospective controlled 8F T2DM RYGB
7 non diabetic obese
4 3 . 6 ± 6 . 8
3 7 . 1 ± 1 1 . 6
NA1 moFasting- and glucose-stimulated GLP-1 similar in S and C
1 month after RYGB, increase in GLP-1 (total and active) in response to oral glucose
Reinehr et al. 2007 [59]Prospective controlled30 obese (26 F)
19 RYGB
11 GB
4 5 . 7 ± 7 . 4 50%2 yDecrease in fasting GLP-1 in both groups
Le Roux et al. 2007 [56]Double-blind randomized prospective controlled7 RYGB
6 AGB
4 4 . 5 ± 2 . 9
4 1 . 9 ± 7 . 5
NA 9 . 5 ± 1 . 5  mo
1 7 ± 1 . 4  mo
Early (2 d) and increased responses of PP GLP-1 in RYGB group only
Laferrère et al. 2008 [49]Prospective controlled 9 F T2D RYGB
10 F T2D diet induced weight loss
4 3 . 3 ± 6 . 2
4 3 . 3 ± 3 . 6
NA1 mo
10 Kg weight loss
Increase in total GLP-1 after oral glucose and GLP-1 AUC after RYGB but not after diet
Peterli et al. 2009 [54]Randomized prospective controlled13 RYGB
14 LSG
4 7 ± 6 . 4
4 5 . 7 ± 6 . 7
NA1 wk and 3 moIncreased PP GLP-1 RYGB > LSG
Clements et al. 2004 [61]Prospective uncontrolled20 obese (15 F) with T2D 5 2 . 7 ± 8 . 8 NA2, 6, and 12 wk postopNo change in fasting GLP-1 at any time point
Rubino et al. 2004 [60]Prospective uncontrolledS: 10 (9 F, 6 T2D) obese RYGB 46.2NA3 wkNo change in fasting GLP-1 in postop
Borg et al. 2006 [57]Prospective uncontrolled6 RYGB48.3NA1, 3, 6 mo postopPP GLP-1 AUC increased at 6 mo postop
Morínigo et al. 2006 [52]Prospective uncontrolled 34 RYGB
(23 F, 12 NGT, 12 IGT, 10 T2D)
4 9 . 1 ± 1 . 0 NGT: 3 4 . 5 ± 1 . 4
IGT: 2 9 . 2 ± 1 . 9
DM: 3 2 . 0 ± 2 . 4
6 wk 12 moIncrease in PP GLP-1 AUC response in IGT and NGT at 6 wk
Increase in PP GLP-1 AUC response in all 3 groups at 12 mo
De Carvalho et al. 2009 [53]Prospective uncontrolled11 NGT (9 F) RYGB
8 AGM (4 T2DM, 4 IGT) (7 F) RYGB
4 6 . 1 ± 2 . 2 7
4 6 . 5 ± 2 . 0 4 %
3 9 . 3 ± 2 . 2 4
3 6 . 4 ± 2 . 6
T1: First evaluation
T2: presurgery
T3: 9 mo after surgery
Increase in GLP-1 levels after OGTT in both groups at T3
Kashyap et al., 2010 [73]Prospective uncontrolled16 (7 F) T2D
9 RYGB
7 GR
4 7 ± 9 10%4 wkNo change in fasting GLP-1 in both groups
Increase in PP GLP-1 response in RYGB group only
Le Roux et al. 2006 [55]Cross-sectional controlled6 RYGB
6 GB
12 obese
15 lean
49.8
46.1
47.1
23.8
NA6 to 36 moHigher postprandial GLP-1 response in RYGB group compared to fasting levels and to other groups
Korner et al. 2007 [58]Cross-sectional controlled13 F non diabetic RYGB
10 F BND
13 F OW
3 1 . 3 ± 1 . 3
3 6 . 1 ± 1 . 7
3 6 . 1 ± 2 . 2
3 5 . 6 ± 2 . 4
2 4 . 6 ± 2 . 3
2 4 . 6 ± 2  mo postopFasting GLP-1 similar in all groups
At 30 min postmeal, GLP-1 higher in RYGB group compared to BND and OW
GLP-1 AUC at 180 min greater in RYBG group compared to other groups
Rodieux et al. 2008 [41]Cross-sectional controlled8 RYGB
6 GB
8 weight matched
4 4 . 9 ± 1 . 8
4 1 . 1 ± 0 . 5
2 9 . 2 ± 0 . 8
4 7 . 8 ± 3 . 3
3 2 . 4 ± 2 . 0
9 to 48 mo (RYGB)
25 to 85 mo
(GB)
No difference in fasting GLP-1 between 3 groups;
Exaggerated GLP-1 PP
Response in RYGB.

Abbreviations: AUC: area under the curve, AGM: abnormal glucose metabolism, BND: adjustable gastric banding, GR: gastric restrictive, IGT: impaired glucose tolerance, LSG: laparoscopic sleeve gastrectomy, NA: data not available, NGT: normal glucose tolerance, OGTT: oral glucose tolerance test, OW: overweight, Postop: postopertaively, PP: postprandial, RYGB: Roux-en-y gastricbBypass, T2D: type 2 diabetes.