The role of gut hormonal aspect in Iraqi patients subjected to sleeve Gastrectomy

Authors

  • Rafida M. Al-Amiri Department of Basic Sciences, College of Dentistry, University of Basrah, Basrah, Iraq.
  • Hanaa S. Kadhum Department of Pathological Analysis, College of Science, University of Basrah, Basrah, Iraq.
  • Falih M. Ali Al-Basra metabolic and Bariatric Surgery Center/Al-Sadder Teaching Hospital, Basrah, Iraq.

DOI:

https://doi.org/10.21123/bsj.2024.8990

Keywords:

Ghrelin, GLP-1, Leptin, Obesity, Sleeve Gastrectomy.

Abstract

There are a variety of obesity surgeries and procedures in which obese individuals undergo. Primarily, they alter satiety and hunger hormone levels in the gut. Moreover, standard method of such procedures can result in long-term weight loss. Ghrelin (Ghr) is a gut hormone that regulates food intake. Laparoscopic Sleeve gastrectomy (LSG) is one method for treating morbid obesity (MO), which could modulate its secretion. The aim of the present study was to demonstrate the effect of sleeve gastrectomy on gut hormones. This study was conducted at Al-Basrah metabolic and Bariatric Surgery Center, Iraq, from December 2021 to March 2022, on 24 patients with morbid obesity treated by sleeve gastrectomy. The included patients were categorized into two main groups according to the periods of their operation. Glucagon –like peptide-1 GLP-1, Ghrelin, Leptin hormones and body mass index (BMI) were significantly decreased after surgery. There was a statistically significant correlation, found between patient's BMI and Leptin level after three months of the surgery, while a statistically significant correlation was found between patient's BMI and GLP-1 level before the surgery when BMI increase by one unit (Kg/m2), the GLP-1 would be increased by half unit 0.45 (50%). The present study has reported that the three hormones GLP-1, Ghrelin and Leptin were decreased after three months of the surgery.

References

Alhabeeb H, AlFaiz A, Kutbi E, AlShahrani D, Alsuhail A, AlRajhi S, et al. Gut hormones in health and obesity: The upcoming role of short chain fatty acids. Nutrients. 2021; 13(2): 481. https://doi.org/10.3390/nu13020481.

Brito H, Santos AC, Preto J, Carvalho D, Freitas P, CRIO Group. Obesity and cancer: the profile of a population who underwent bariatric surgery. Obes Surg. 2021; 31(11): 4682-91. https://doi.org/10.1007/s11695-021-05626-0.

Akalestou E, Miras AD, Rutter GA, le Roux CW. Mechanisms of weight loss after obesity surgery. Endocr Rev. 2022; 43(1): 19-3 https://doi.org/10.1210/endrev/bnab022.

Nguyen NT, Brethauer SA, Morton JM, Ponce J, Rosenthal RJ, editors. The ASMBS textbook of bariatric surgery. Cham: Springer International Publishing; 2020. https://doi.org/10.1007/978-3-030-27021-6.

Lopez-Nava G, Negi A, Bautista-Castaño I, Rubio MA, Asokkumar R. Gut and metabolic hormones changes after endoscopic sleeve gastroplasty (ESG) vs. laparoscopic sleeve gastrectomy (LSG). Obes Surg. 2020; 30: 2642-51. https://doi.org/10.1007/s11695-020-04541-0.

Cheskin LJ, Hill C, Adam A, Fayad L, Dunlap M, Badurdeen D, et al Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy: a case-matched study. Gastrointest Endosc .2020; 91(2): 3429. https://doi.org/10.1016/j.gie.2019.09.029.

Akki R, Raghay K, Errami M. Potentiality of ghrelin as antioxidant and protective agent. Redox Rep. 2021; 26(1): 71-9. https://doi.org/10.1080/13510002.2021.1913374.

Kehagias I, Zygomalas A, Karavias D, Karamanakos S. Sleeve gastrectomy: have we finally found the holy grail of bariatric surgery? A review of the literature. Eur Rev Med Pharmacol Sci. 2016; 20(23): 4930-42.

Wang L, Shi C, Yan H, Xia M, Zhu X, Sun X, et al. Acute effects of sleeve gastrectomy on glucose variability, glucose metabolism, and ghrelin response. Obes Surg. 2021; 31: 4005-14. https://doi.org/10.1007/s11695-021-05534-3

Sadiq CH, Hussein RH, Maulood IM. Ghrelin and Leptin and Their Relations with Insulin Resistance in Diabetes Mellitus Type 2 Patients. Baghdad Sci J. 2022; 19: 0033. http://dx.doi.org/10.21123/bsj.2022.19.1.0033.

Quiñones M, Fernø J, Al-Massadi O. Ghrelin and liver disease. Rev Endocr Metab Disord. 2020; 21: 45-56. https://doi.org/10.1007/s11154-019-09528-6.

Aukan MI, Nymo S, Ollestad KH, Boyesen GA, DeBenedictis JN, Rehfeld JF, et al. Differences in gastrointestinal hormones and appetite ratings among obesity classes. Appetite. 2022; 171: 105940. https://doi.org/10.1016/j.appet.2022.105940.

Müller TD, Finan B, Bloom SR, D'Alessio D, Drucker DJ, Flatt PR, et al. Glucagon-like peptide 1(GLP-1). Mol Metab. 2019; 30: 72-130.https://doi.org/10.1016/j.molmet.2019.09.010.

Heusschen L, Berendsen AA, Cooiman MI, Deden LN, Hazebroek EJ, Aarts EO. Optimizing multivitamin supplementation for sleeve gastrectomy patients. Obes Surg. 2021; 31: 2520-8. https://doi.org/10.1007/s11695-021-05282-4.

Kumar R, Mal K, Razaq MK, Magsi M, Memon MK, Memon S, et al. Association of leptin with obesity and insulin resistance. Cureus. 2020; 12(12). https://doi.org/10.7759/cureus.12178.

Ali KA, Al-Kirvi EN, JJ-Shaban SA. Relation between Serum Leptin, Lipid Profiles and other biomarkers levels in patients with type 2 diabetic. Baghdad Sci J. 2010; 7 (1): 1-9. https://doi.org/10.21123/bsj.2010.7.1.678-686.

Abou-Samra M, Venema K, Ayoub Moubareck C, Karavetian M. The Association of Peptide Hormones with Glycemia, Dyslipidemia, and Obesity in Lebanese Individuals. Metabolites. 2022; 12(11): 1051.https://doi.org/10.3390/metabo12111051.

Beckman LM, Beckman TR, Sibley SD, Thomas W, Ikramuddin S, Kellogg TA, et al. Changes in gastrointestinal hormones and leptin after Roux‐en‐Y gastric bypass surgery. Braspen J. 2011; 35(2): 169-80. https://doi.org/10.1177/0148607110381403

Collins KH, Gui C, Ely EV, Lenz KL, Harris CA, Guilak F, et al. Leptin mediates the regulation of muscle mass and strength by adipose tissue. J Physiol. 2022 ; 600(16): 3795-817. https://doi.org/10.1113/jp283034.

Miguéns-Gómez A, Casanova-Martí À, Blay MT, Terra X, Beltrán-Debón R, Rodríguez-Gallego E, et al. Glucagon-like peptide-1 regulation by food proteins and protein hydrolysates.

Nutr Res Rev. 2021; 34(2): 259-75.https://doi.org/10.1017/S0954422421000019.

Chaudhari SN, Harris DA, Aliakbarian H, Luo JN, Henke MT, Subramaniam R, et al. Bariatric surgery reveals a gut-restricted TGR5 agonist with anti-diabetic effects. Nat Chem Biol. 2021;17(1):20-9. https://doi.org/10.1038/s41589-020-0604-z.

Hellström PM. GLP-1 analogue liraglutide as adjunct treatment in diabetes type 2 after failed bariatric/metabolic surgery. Ann Transl Med. 2019;7(Suppl 6): S240. https://doi.org/10.21037/atm.2019.08.94.

Xiao Y, Tan C, Nie X, Li B, You M, Lan Y, et al. Rise in Postprandial GLP-1 Levels After Roux-en-Y Gastric Bypass: Involvement of the Vagus Nerve–Spleen Anti-inflammatory Axis in Type 2 Diabetic Rats. Obes Surg. 2022; 32(4): 1077-85. https://doi.org/10.1007/s11695-021-05877-x.

Lu VB, Gribble FM, Reimann F. Nutrient-induced cellular mechanisms of gut hormone secretion. Nutrients. 2021; 13(3): 883.https://doi.org/10.3390/nu13030883.

Kim KS, Peck BC, Hung YH, Koch-Laskowski K, Wood L, Dedhia PH, et al. Vertical sleeve gastrectomy induces enteroendocrine cell differentiation of intestinal stem cells through bile acid signaling. JCI insight. 2022; 7(11): e154302. https://doi.org/10.1172/jci.insight.154302.

Cavin JB, Couvelard A, Lebtahi R, Ducroc R, Arapis K, Voitellier E, et al. Differences in alimentary glucose absorption and intestinal disposal of blood glucose after Roux-en-Y gastric bypass vs sleeve gastrectomy. Gastroenterology. 2016; 150(2): 454-64. https://doi.org/10.1053/j.gastro.2015.10.009.

Mumphrey MB, Hao Z, Townsend RL, Patterson LM, Berthoud HR. Sleeve gastrectomy does not cause hypertrophy and reprogramming of intestinal glucose metabolism in rats. Obes Surg. 2015; 25: 1468-73. https://doi.org/10.1007/s11695-014-1547-9.

Sandoval DA, Patti ME. Glucose metabolism after bariatric surgery: implications for T2DM remission and hypoglycaemia. Nat Rev Endocrinol. 2023; 19(3): 164-76. https://doi.org/10.1038/s41574-022-00757-5.

Frühbeck G, Kiortsis DN, Catalán V. Precision medicine: diagnosis and management of obesity. Lancet Diabetes Endocrinol. 2018; 6(3): 164-6. https://doi.org/10.1016/s2213-8587(17)30312-1.

Woźniewska P, Diemieszczyk I, Hady H. Complications associated with laparoscopic sleeve gastrectomy–a review. Gastroenterology Review/ Prz Gastroenterol. 2021; 16(1): 5-9. https://doi.org/10.5114/pg.2021.104733.

McCarty TR, Jirapinyo P, Thompson CC. Effect of sleeve gastrectomy on ghrelin, GLP-1, PYY, and GIP gut hormones: a systematic review and meta-analysis. Ann Surg. 2020; 272(1): 72-80. https://doi.org/10.1097/sla.0000000000003614.

Salman MA, El-Ghobary M, Soliman A, El Sherbiny M, Abouelregal TE, Albitar A, et al. Long-term changes in leptin, chemerin, and ghrelin levels following Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Obes Surg. 2020; 30: 1052-60. https://doi.org/10.1007/s11695-019-04254-z.

Kalinowski P, Paluszkiewicz R, Wróblewski T, Remiszewski P, Grodzicki M, Bartoszewicz Z, et al. Ghrelin, leptin, and glycemic control after sleeve gastrectomy versus Roux-en-Y gastric bypass—results of a randomized clinical trial. Surg Obes Relat Dis. 2017; 13(2): 181-8. https://doi.org/10.1016/j.soard.2016.08.025.

Šebunova N, Štšepetova J, Kullisaar T, Suija K, Rätsep A, Junkin I. Changes in adipokine levels and metabolic profiles following bariatric surgery. BMC endocrine disorders. 2022 ;22(1):1-2. https://doi.org/10.1186/s12902-022-00942-7.

Salminen P, Helmiö M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JMA. 2018; 319(3): 241-54.https://doi.org/10.1001/jama.2017.20313.

Ceccarini G, Pelosini C, Ferrari F, Magno S, Vitti J, Salvetti G, et al. Serum IGF-binding protein 2 (IGFBP-2) concentrations change early after gastric bypass bariatric surgery revealing a possible marker of leptin sensitivity in obese subjects. Endocrine. 2019; 65: 86-93. https://doi.org/10.1007/s12020-019-01915-y.

Santo MA, Riccioppo D, Pajecki D, Kawamoto F, de Cleva R, Antonangelo L, et al . Weight regain after gastric bypass: influence of gut hormones. Obes Surg. 2016; 26: 919-25. https://doi.org/10.1007/s11695-015-1908-z.

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The role of gut hormonal aspect in Iraqi patients subjected to sleeve Gastrectomy. Baghdad Sci.J [Internet]. [cited 2024 May 3];21(11). Available from: https://bsj.uobaghdad.edu.iq/index.php/BSJ/article/view/8990