Impaired Enterohormone Response Following a Liquid Test Meal in Gastrectomized Patients

Abstract

Background: Total gastrectomy (TG) is responsible for symptoms or disturbance of alimentary status (changes in body weight, food intake per meal and frequency of meal per day) which, in turn are responsible for weight loss and malnutrition. The study evaluates the gut hormone responses in totally gastrectomized (TG) patients after a liquid meal test. Methods: Twenty total gastrectomized cancer-free patients (12 M, 8 F, 56.4 ± 10.2 years, BMI 21.4 ± 2.2 kg/m²) and 10 healthy volunteers (4 M, 6 F, 48.0 ± 12.7 years, BMI 26.7 ± 3.0 kg/m² ) drank a liquid meal (1.25 kcal/mL) at the rate of 50 mL/5′ min for a maximum of 30 min. Satiety score was assessed and blood sample was taken at different time points. Results: The time response course, particularly for insulin, glucose-like pepetide-1, and cholecystokinin, significantly differed between TG patients and controls. Conclusions: Our results may help to better understand hormone responses triggered by the faster arrival of nutrients in the small bowel and to explain some post-TG symptoms.

The association between weight change after gastric cancer surgery and type 2 diabetes risk: A nationwide cohort study

“…Thus, further studies of the effects of gastrointestinal hormones on type 2 diabetes after gastric cancer surgery are warranted. Changes in gastrointestinal hormones after foregut surgery affect body weight, satiety and insulin resistance, 28,29 and duodenal mucosal resurfacing is performed to treat type 2 diabetes, appreciating such roles of the foregut in metabolism. 30 An increase in the risk of type 2 diabetes with excessive weight decrease might be related to malnutrition and sarcopenia, as a decrease in skeletal muscle contributes to insulin resistance, which is well known to predispose patients to type 2 diabetes.…”

“…Thus, further studies of the effects of gastrointestinal hormones on type 2 diabetes after gastric cancer surgery are warranted. Changes in gastrointestinal hormones after foregut surgery affect body weight, satiety and insulin resistance, 28 , 29 and duodenal mucosal resurfacing is performed to treat type 2 diabetes, appreciating such roles of the foregut in metabolism. 30 …”