Longitudinal changes in pancreatic and adipocyte hormones following Roux-en-Y gastric bypass surgery

Diabetologia. 2008 Oct;51(10):1901-11. doi: 10.1007/s00125-008-1118-5. Epub 2008 Aug 15.


Aims/hypothesis: Bariatric surgery is an effective treatment for severe obesity, as in addition to dramatic weight loss, co-morbidities such as type 2 diabetes are frequently resolved. Although altered gastrointestinal peptide hormone secretion and its relationship with post-surgical improvements in insulin sensitivity has been studied, much less is known about long-term changes in pancreatic and adipose tissue-derived hormones. Our objective was to conduct a comprehensive longitudinal investigation of the endocrine changes following Roux-en-Y gastric bypass surgery (RYGBP), focusing on pancreatic and adipocyte hormones and systemic markers of inflammation.

Methods: Nineteen severely obese women (BMI 45.6 +/- 1.6 kg/m(2)) were studied prior to RYGBP, and at 1, 3, 6, and 12 months after RYGBP. Body composition was assessed before surgery and at 1 and 12 months.

Results: Pre-surgical adiposity was correlated with circulating adipocyte hormones (leptin, visfatin) and inflammatory molecules (IL-6, high sensitivity C-reactive protein [hsCRP], monocyte chemoattractant protein-1). As expected, RYGBP reduced fat mass and fasting insulin and glucose concentrations. In addition, reductions of fasting pancreatic polypeptide (PP) and glucagon concentrations were observed at 1 and 3 months, respectively. In the 12 months following RYGBP, concentrations of most adipocyte hormones (leptin, acylation-stimulating hormone and visfatin, but not retinol-binding hormone-4) and inflammatory molecules (IL-6, hsCRP and soluble intracellular adhesion molecule-1) were significantly reduced. Reductions of insulin resistance (measured by homeostasis model assessment of insulin resistance) were independently associated with changes of glucagon, visfatin and PP. Pre-surgical HMW adiponectin concentrations independently predicted losses of body weight and fat mass.

Conclusions/interpretation: These results suggest that pancreatic and adipocyte hormones may contribute to the long-term resolution of insulin resistance after RYGBP.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipocytes / metabolism*
  • Adult
  • C-Reactive Protein / metabolism
  • Chemokine CCL2 / metabolism
  • Female
  • Gastric Bypass / methods*
  • Glucagon / metabolism
  • Glucose / metabolism
  • Humans
  • Interleukin-6 / metabolism
  • Leptin / metabolism
  • Longitudinal Studies
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / pathology
  • Obesity, Morbid / surgery*
  • Pancreas / metabolism*
  • Retinol-Binding Proteins, Plasma / metabolism
  • Time Factors


  • Chemokine CCL2
  • Interleukin-6
  • Leptin
  • RBP4 protein, human
  • Retinol-Binding Proteins, Plasma
  • C-Reactive Protein
  • Glucagon
  • Glucose