Chronic elevation of systemic glucagon-like peptide-1 following surgical weight loss: association with nausea and vomiting and effects on adipokines

Obes Surg. 2015 Feb;25(2):386-91. doi: 10.1007/s11695-014-1507-4.

Abstract

We determined whether persistent nausea and vomiting (N/V) symptoms following Roux-en-Y gastric bypass surgery is due to elevated systemic glucagon-like peptide-1 (GLP-1) and leptin in female non-diabetic subjects. Subjects with N/V post-Roux-en-Y gastric bypass (RYGB) surgery had significantly elevated fasting GLP-1 levels compared to that with post-operative asymptomatic subjects and to morbidly obese, obese and lean subjects not undergoing surgery. Weight loss, glycaemia, insulin and post-prandial GLP-1 levels were similar in all post-operative subjects. Despite comparable BMI, leptin was significantly lower in symptomatic subjects. Furthermore, leptin secretion from subcutaneous adipose tissue was inhibited by GLP-1 (0.1-1.0 nM; n = 6). Persistent N/V following RYGB surgery is associated with elevated fasting GLP-1, but lower leptin levels. The latter may be a consequence of the direct GLP-1 inhibition of leptin secretion from adipose tissue.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipokines / blood
  • Adult
  • Blood Glucose / metabolism
  • Case-Control Studies
  • Female
  • Gastric Bypass / adverse effects
  • Glucagon-Like Peptide 1 / blood*
  • Humans
  • Insulin / blood
  • Insulin Resistance / physiology
  • Leptin / blood
  • Middle Aged
  • Nausea / blood*
  • Nausea / etiology
  • Obesity, Morbid / blood
  • Obesity, Morbid / surgery*
  • Postoperative Nausea and Vomiting / blood*
  • Postoperative Nausea and Vomiting / etiology
  • Postprandial Period
  • Vomiting / blood*
  • Vomiting / etiology
  • Weight Loss / physiology*

Substances

  • Adipokines
  • Blood Glucose
  • Insulin
  • Leptin
  • Glucagon-Like Peptide 1