ORIGINAL ARTICLE   

Minerva Chirurgica 2019 February;74(1):7-13

DOI: 10.23736/S0026-4733.18.07681-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

The main participation of the enterohormone GLP-1 after bariatric surgery

Alejandra MORENO-ARCINIEGAS ¹, Joshua FALCKENHEINER-SORIA ¹, José BANCALERO-DE LOS REYES ², Alonso CAMACHO-RAMÍREZ ¹, María de los ANGELES MAYO-OSSORIO ³, J. Manuel PACHECO-GARCÍA ³, Gonzalo M. PÉREZ-ARANA ⁴, J. Arturo PRADA-OLIVEIRA ⁴ ✉

¹ Department of Surgery, Puerto Real Hospital, University of Cádiz, Cádiz, Spain; ² Hospital of Badajoz, SES (Servicio Extremeño de Salud), Badajoz, Spain; ³ Department of Surgery, Puerta del Mar Hospital, University of Cádiz, Cádiz, Spain; ⁴ Department of Human Anatomy and Embryology, Faculty of Medicine, University of Cádiz, Cádiz, Spain

BACKGROUND: Numerous hypotheses are called to explain the beneficial effect on glucose metabolism after bariatric surgery. Some authors advocate for the secretion and release of various substances with endocrine functions for the explanation on this event. One of the substances most marked as effector, with contrasting effects but controversial data, is GLP-1.
METHODS: Our study was performed in healthy male Wistar rats, to avoid the absence of confounding factors such as T2DM and obesity. In order to know the adaptation of GLP-1 secretion after surgery 5 groups were designated: two control groups (fasting and surgical stress), and three surgical groups (gastric sleeve, 50% resection of the midgut and the Roux en Y gastric bypass). After three months the GLP-1 synthesis in the different portions of the small intestine and the expression of the membrane receptors in pancreatic islet cells were studied by immunohistochemical techniques.
RESULTS: There was a significant increase in the number of secretory cells in ileum, duodenum and jejunum in mixed (RYGB) and malabsorptive (RI50) surgical groups. An elevation of pancreatic receptors signal was also observed in the same techniques versus controls.
CONCLUSIONS: Our data indicate that intestinal secretion of GLP-1 and its sensitivity to the pancreatic changes were increased like a response of an adaptive effect to the mechanical aggression of the digestive tube and as alteration of nutrient flow after surgery.

KEY WORDS: Pancreas - Diabetes mellitus - Bariatric-surgery - Insulin-secreting cells