Can Metabolite and Hormone Profiles Provide a Rationale for Choosing Between Bariatric Procedures?
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Can Metabolite and Hormone Profiles Provide a Rationale for Choosing Between Bariatric Procedures? / Guimarães, Marta; Pereira, Sofia S.; Holst, Jens J.; Nora, Mário; Monteiro, Mariana P.
In: Obesity Surgery, Vol. 31, 2021, p. 2174-2179.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Can Metabolite and Hormone Profiles Provide a Rationale for Choosing Between Bariatric Procedures?
AU - Guimarães, Marta
AU - Pereira, Sofia S.
AU - Holst, Jens J.
AU - Nora, Mário
AU - Monteiro, Mariana P.
PY - 2021
Y1 - 2021
N2 - Purpose: There are no formal guidelines for choosing among different bariatric surgery procedures for obesity treatment. So, our aim was to evaluate whether post-absorptive metabolite and hormone profiles could aid the surgeon decision when considering bariatric surgery interventions. Materials and Methods: Subjects (N=38) previously submitted to biliopancreatic diversion with duodenal switch (BPD-DS, n=9), single anastomosis duodenal–ileum bypass with sleeve gastrectomy (SADI-S, n= 9), long biliopancreatic limb Roux-en-Y gastric bypass (RYGB-M, n= 11), and classic RYGB (RYGB-C, n= 9) underwent a mixed meal test to evaluate post-absorptive glucose, total amino acid (AA), insulin, and GLP-1 profiles. Results: Glucose, AA, insulin, and GLP-1 excursions were lower after BPD-DS when compared to other surgeries. SADI-S resulted in lower glucose but similar AA and insulin excursions when compared to RYGB-M. The highest GLP-1 excursion was observed after RYGB-M. There were no significant differences in glucose or AA post-prandial excursions between RYGB procedures, yet insulin excursion was higher after RYGB-C when compared to RYGB-M. Conclusion: Post-prandial metabolite excursions diverge across bariatric procedures being lowest after BPD-DS, intermediate after SADI-S, and highest after RYGB, in parallel with the anti-diabetic efficacy and malabsorption risk reported for each type of intervention. SADI-S and RYGB-M seem to elicit similar post-prandial hormonal profiles, with potentially lower risk of protein malnutrition when compared to BPD-DS. Post-absorptive metabolite and hormone profiles could provide a rationale as decision-aid when choosing among bariatric surgery interventions, as long as these findings are validated in future trials.
AB - Purpose: There are no formal guidelines for choosing among different bariatric surgery procedures for obesity treatment. So, our aim was to evaluate whether post-absorptive metabolite and hormone profiles could aid the surgeon decision when considering bariatric surgery interventions. Materials and Methods: Subjects (N=38) previously submitted to biliopancreatic diversion with duodenal switch (BPD-DS, n=9), single anastomosis duodenal–ileum bypass with sleeve gastrectomy (SADI-S, n= 9), long biliopancreatic limb Roux-en-Y gastric bypass (RYGB-M, n= 11), and classic RYGB (RYGB-C, n= 9) underwent a mixed meal test to evaluate post-absorptive glucose, total amino acid (AA), insulin, and GLP-1 profiles. Results: Glucose, AA, insulin, and GLP-1 excursions were lower after BPD-DS when compared to other surgeries. SADI-S resulted in lower glucose but similar AA and insulin excursions when compared to RYGB-M. The highest GLP-1 excursion was observed after RYGB-M. There were no significant differences in glucose or AA post-prandial excursions between RYGB procedures, yet insulin excursion was higher after RYGB-C when compared to RYGB-M. Conclusion: Post-prandial metabolite excursions diverge across bariatric procedures being lowest after BPD-DS, intermediate after SADI-S, and highest after RYGB, in parallel with the anti-diabetic efficacy and malabsorption risk reported for each type of intervention. SADI-S and RYGB-M seem to elicit similar post-prandial hormonal profiles, with potentially lower risk of protein malnutrition when compared to BPD-DS. Post-absorptive metabolite and hormone profiles could provide a rationale as decision-aid when choosing among bariatric surgery interventions, as long as these findings are validated in future trials.
KW - Bariatric surgery
KW - biliopancreatic diversion with duodenal switch
KW - obesity
KW - Roux-en-Y Gastric Bypass
KW - singleanastomosis duodeno-ileal bypass with sleeve gastrectomy
U2 - 10.1007/s11695-021-05246-8
DO - 10.1007/s11695-021-05246-8
M3 - Journal article
C2 - 33511559
AN - SCOPUS:85099989982
VL - 31
SP - 2174
EP - 2179
JO - Obesity Surgery
JF - Obesity Surgery
SN - 0960-8923
ER -
ID: 256938427