The long-term failure of RYGB surgery in improving T2DM is related to hyperinsulinism

Pérez-Arana, Gonzalo-Martín; Díaz-Gómez, Alfredo; Reyes, José Bancalero de los; Camacho-Ramírez, Alonso; Fernández-Vivero, José; Ribelles-García, Antonio; Gomar, David Almorza; Carrasco-Molinillo, Carmen; Mateo-Gavira, Isabel; Oliveira, José Arturo Prada

doi:10.1016/j.aanat.2021.151855

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…Time between surgery and tissue harvest ranged between 11 days and six months. Taste receptor quantification was carried out using PCR for mRNA analysis in six studies [ 35 , 50 , 54 , 57 , 58 , 61 ], protein analysis techniques (such as Western blotting, immunohistochemistry, or mass spectrometry) in another five [ 52 , 53 , 56 , 68 , 69 ], or both in 10 studies [ 51 , 55 , 59 , 60 , 62 – 67 ]. Key characteristics of animal studies are outlined in Table 3 .…”

Section: Resultsmentioning

confidence: 99%

“…Of the animal studies, five reported an increase in SGLT1 mRNA and protein expression in the alimentary limb after RYGB [ 50 – 52 ], and DJB [ 59 ] and in the interposed ileal segment after IIP [ 69 ]. No change to mRNA levels were observed in the alimentary limb of one study [ 58 ] or the biliopancreatic limb [ 50 , 58 ], or colon [ 57 ] after RYGB.…”

Section: Resultsmentioning

confidence: 99%

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The effect of bariatric surgery on the expression of gastrointestinal taste receptors: A systematic review

Walmsley,

Chong,

Hii

et al. 2024

Rev Endocr Metab Disord

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Gastrointestinal nutrient sensing via taste receptors may contribute to weight loss, metabolic improvements, and a reduced preference for sweet and fatty foods following bariatric surgery. This review aimed to investigate the effect of bariatric surgery on the expression of oral and post-oral gastrointestinal taste receptors and associations between taste receptor alterations and clinical outcomes of bariatric surgery. A systematic review was conducted to capture data from both human and animal studies on changes in the expression of taste receptors in oral or post-oral gastrointestinal tissue following any type of bariatric surgery. Databases searched included Medline, Embase, Emcare, APA PsychInfo, Cochrane Library, and CINAHL. Two human and 21 animal studies were included. Bariatric surgery alters the quantity of many sweet, umami, and fatty acid taste receptors in the gastrointestinal tract. Changes to the expression of sweet and amino acid receptors occur most often in intestinal segments surgically repositioned more proximally, such as the alimentary limb after gastric bypass. Conversely, changes to fatty acid receptors were observed more frequently in the colon than in the small intestine. Significant heterogeneity in the methodology of included studies limited conclusions regarding the direction of change in taste receptor expression induced by bariatric surgeries. Few studies have investigated associations between taste receptor expression and clinical outcomes of bariatric surgery. As such, future studies should look to investigate the relationship between bariatric surgery-induced changes to gut taste receptor expression and function and the impact of surgery on taste preferences, food palatability, and eating behaviour.Registration code in PROSPERO: CRD42022313992

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The effect of bariatric surgery on the expression of gastrointestinal taste receptors: A systematic review

Walmsley,

Chong,

Hii

et al. 2024

Rev Endocr Metab Disord

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“…This is a paradoxical situation given that RYGB also stimulates insulin secretion and limits high glucose levels. However, supporting these observations, long-term increased alpha cell mass has been observed in Wistar rodent models after RYGB ( 41 ), and elevated plasma glucagon levels have been observed after the oral glucose tolerance test (OGTT) but not after intravenous glucose administration in T2DM patients after RYGB ( 39 ). Furthermore, glucagon gene expression and glucagon expression are increased in patients after RYGB, as determined by small intestine biopsy, indicating new sources of alternative glucagon secretion.…”

Section: Glucagon and Metabolic Surgerymentioning

confidence: 86%

The role of glucagon after bariatric/metabolic surgery: much more than an “anti-insulin” hormone

et al. 2023

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The biological activity of glucagon has recently been proposed to both stimulate hepatic glucose production and also include a paradoxical insulinotropic effect, which could suggest a new role of glucagon in the pathophysiology type 2 diabetes mellitus (T2DM). An insulinotropic role of glucagon has been observed after bariatric/metabolic surgery that is mediated through the GLP-1 receptor on pancreatic beta cells. This effect appears to be modulated by other members of the proglucagon family, playing a key role in the beneficial effects and complications of bariatric/metabolic surgery. Glucagon serves a dual role after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). In addition to maintaining blood glucose levels, glucagon exhibits an insulinotropic effect, suggesting that glucagon has a more complex function than simply an “anti-insulin hormone”.

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“…Contrary to our results, no alterations in alpha-cell mass or glucagon staining islet cells were observed by others after RYGB surgery [ 20 , 32 , 35 ] whilst recent study by Pérez-Arana et. al observed increased alpha cell mass after RYGB [ 73 ]. The reasons for this are unclear but may be related to the different animal models used, their age and effects on islet cell transitioning events.…”

Section: Discussionmentioning

confidence: 99%

Differential effects of RYGB surgery and best medical treatment for obesity-diabetes on intestinal and islet adaptations in obese-diabetic ZDSD rats

et al. 2022

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Modification of gut-islet secretions after Roux-En-Y gastric bypass (RYBG) surgery contributes to its metabolic and anti-diabetic benefits. However, there is limited knowledge on tissue-specific hormone distribution post-RYGB surgery and how this compares with best medical treatment (BMT). In the present study, pancreatic and ileal tissues were excised from male Zucker-Diabetic Sprague Dawley (ZDSD) rats 8-weeks after RYGB, BMT (daily oral dosing with metformin 300mg/kg, fenofibrate 100mg/kg, ramipril 1mg/kg, rosuvastatin 10mg/kg and subcutaneous liraglutide 0.2mg/kg) or sham operation (laparotomy). Insulin, glucagon, somatostatin, PYY, GLP-1 and GIP expression patterns were assessed using immunocytochemistry and analyzed using ImageJ. After RYGB and BMT, body weight and plasma glucose were decreased. Intestinal morphometry was unaltered by RYGB, but crypt depth was decreased by BMT. Intestinal PYY cells were increased by both interventions. GLP-1- and GIP-cell counts were unchanged by RYGB but BMT increased ileal GLP-1-cells and decreased those expressing GIP. The intestinal contents of PYY and GLP-1 were significantly enhanced by RYGB, whereas BMT decreased ileal GLP-1. No changes of islet and beta-cell area or proliferation were observed, but the extent of beta-cell apoptosis and islet integrity calculated using circularity index were improved by both treatments. Significantly decreased islet alpha-cell areas were observed in both groups, while beta- and PYY-cell areas were unchanged. RYGB also induced a decrease in islet delta-cell area. PYY and GLP-1 colocalization with glucagon in islets was significantly decreased in both groups, while co-staining of PYY with glucagon was decreased and that with somatostatin increased. These data characterize significant cellular islet and intestinal adaptations following RYGB and BMT associated with amelioration of obesity-diabetes in ZDSD rats. The differential responses observed and particularly those within islets, may provide important clues to the unique ability of RYGB to cause diabetes remission.

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The long-term failure of RYGB surgery in improving T2DM is related to hyperinsulinism

Cited by 7 publications

References 23 publications

The effect of bariatric surgery on the expression of gastrointestinal taste receptors: A systematic review

The effect of bariatric surgery on the expression of gastrointestinal taste receptors: A systematic review

The role of glucagon after bariatric/metabolic surgery: much more than an “anti-insulin” hormone

Differential effects of RYGB surgery and best medical treatment for obesity-diabetes on intestinal and islet adaptations in obese-diabetic ZDSD rats

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