Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=8166318 https://repositorio.unifesp.br/handle/11600/59349 |
Resumo: | OBJECTIVE: To evaluate and compare the role of gastrointestinal hormones – GHRELIN, peptide YY 3-36 (PYY 3-36), glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-2 (GLP-2) - and LEPTIN in patients with and without weight regain undergoing Roux-en-Y gastric bypass after five years of the surgical procedure. METHODS: This is an observational, cross-sectional study, where 72 individuals divided into 3 paired groups: Group WR (WITH WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass with weight regain; Group WWR (WITHOUT WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass without weight regain and Group NO-OP (NON-OPERATED OBESE): 24 obese patients who are candidates for bariatric surgery. Patients with weight regain, defined as the increase of 5kg/m2 in BMI, taking as reference the minimum BMI reached during the postoperative period and the current BMI. The overall patients underwent clinical, biochemical, anthropometric and endoscopic evaluation. Hormone evaluation was performed in four settings – fasting, 30, 60 and 120 minutes - after standard meal intake, considering that the secretion of gastrointestinal hormones is affected by nutrient intake. RESULTS: For GLP-1, GLP-2 and PYY, values in the control group (NO-OP) did not change significantly. In the WR and WWR there was a sharp elevation at 30 minutes followed by a decrease at 60 and 120 minutes, ending with mean values still higher than baseline. Variations in ghrelin were not considered statistically significant. For GIP, the three groups showed similar behavior, with an increase at 30 minutes and a decrease at 60 and 120 minutes; however, in the overall evaluation (baseline period up to 120min), the WWR was the group in which GIP reached its lowest variation compared to baseline, and a statistical difference was found compared to the NO-OP and the WR groups. For leptin, the RW was similar to control, while the WWR showed significantly lower mean values. CONCLUSIONS: Non-operated obese individuals showed a postprandial secretion profile of PYY, GLP-1 and GLP-2, distinct from patients undergoing Roux-en-Y gastric bypass. In patients with weight regain, leptin concentrations were significantly higher when compared to patients without weight regain, thus suggesting a probable resistance to the action of this hormone. Patients without weight regain showed less variation in GIP, which implies a possible relation to the restoration of the secretory process after glucose control. GLP-1, GLP-2, PYY and GHRELIN showed no correlation with weight regain. Further studies should be conducted to better identify the mechanisms responsible for the findings reported by the current investigation, as well as clarifications on other conditions induced by Roux-en-Y gastric bypass. |
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Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de rouxEvaluation of gastrointestinal hormones and leptin in patients with and without weight regain five years after Roux-en-Y gastric bypassBariatric SurgeryWeight RegainGastroinstestinal HormonesLeptinObesityGastric BypassCirurgia BariátricaReganho De PesoHormônios GastrointestinaisLeptinaObesidadeBypass GástricoOBJECTIVE: To evaluate and compare the role of gastrointestinal hormones – GHRELIN, peptide YY 3-36 (PYY 3-36), glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-2 (GLP-2) - and LEPTIN in patients with and without weight regain undergoing Roux-en-Y gastric bypass after five years of the surgical procedure. METHODS: This is an observational, cross-sectional study, where 72 individuals divided into 3 paired groups: Group WR (WITH WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass with weight regain; Group WWR (WITHOUT WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass without weight regain and Group NO-OP (NON-OPERATED OBESE): 24 obese patients who are candidates for bariatric surgery. Patients with weight regain, defined as the increase of 5kg/m2 in BMI, taking as reference the minimum BMI reached during the postoperative period and the current BMI. The overall patients underwent clinical, biochemical, anthropometric and endoscopic evaluation. Hormone evaluation was performed in four settings – fasting, 30, 60 and 120 minutes - after standard meal intake, considering that the secretion of gastrointestinal hormones is affected by nutrient intake. RESULTS: For GLP-1, GLP-2 and PYY, values in the control group (NO-OP) did not change significantly. In the WR and WWR there was a sharp elevation at 30 minutes followed by a decrease at 60 and 120 minutes, ending with mean values still higher than baseline. Variations in ghrelin were not considered statistically significant. For GIP, the three groups showed similar behavior, with an increase at 30 minutes and a decrease at 60 and 120 minutes; however, in the overall evaluation (baseline period up to 120min), the WWR was the group in which GIP reached its lowest variation compared to baseline, and a statistical difference was found compared to the NO-OP and the WR groups. For leptin, the RW was similar to control, while the WWR showed significantly lower mean values. CONCLUSIONS: Non-operated obese individuals showed a postprandial secretion profile of PYY, GLP-1 and GLP-2, distinct from patients undergoing Roux-en-Y gastric bypass. In patients with weight regain, leptin concentrations were significantly higher when compared to patients without weight regain, thus suggesting a probable resistance to the action of this hormone. Patients without weight regain showed less variation in GIP, which implies a possible relation to the restoration of the secretory process after glucose control. GLP-1, GLP-2, PYY and GHRELIN showed no correlation with weight regain. Further studies should be conducted to better identify the mechanisms responsible for the findings reported by the current investigation, as well as clarifications on other conditions induced by Roux-en-Y gastric bypass.OBJETIVO: Avaliar e comparar os hormônios gastrointestinais - GRELINA, PYY 3-36, GLP-1, GIP, GLP-2 e LEPTINA em pacientes com e sem reganho do peso após cinco anos da gastroplastia em Y de Roux. MÉTODOS: Trata-se de um estudo observacional, transversal, onde foram avaliados 72 indivíduos divididos em 3 grupos pareados - Grupo COM-RP: 24 pacientes submetidos a gastroplastia em Y de Roux e que apresentaram reganho do peso. Grupo SEM-RP: 24 pacientes submetidos a gastroplastia em Y de Roux e que não apresentaram reganho ponderal e Grupo NÃO-OP (controle não operado): 24 pacientes obesos candidatos a cirurgia bariátrica. O reganho do peso foi definido como o aumento de 5kg/m2 no IMC, tomando-se como referência o IMC mínimo atingido durante o pós-operatório. Os pacientes foram submetidos a avaliação clínica, bioquímica, antropométrica e endoscópica. A coleta de sangue para avaliação dos hormônios foi realizada em 4 tempos – jejum, 30, 60 e 120 minutos - após ingestão de refeição padrão. RESULTADOS: Para GLP-1, GLP-2 e PYY os valores no grupo NÃO-OP não se alteraram significativamente. Nos grupos COM-RP e SEM-RP houve elevação acentuada aos 30 minutos seguida de queda aos 60 e 120 minutos, terminando com valores médios ainda superiores ao basal. As variações de grelina não foram consideradas estatisticamente significantes. Para o GIP, os três grupos apresentaram comportamento semelhante, com aumento aos 30 minutos e queda aos 60 e 120 minutos, entretanto, na avaliação global (período basal até 120min), o grupo SEM-RP foi o que apresentou menor variação deste hormônio em relação ao basal, com diferença estatística em relação ao grupo NÃO-OP e COM-RP. Quanto a leptina, o grupo COM-RP foi semelhante ao NÃO-OP enquanto o grupo SEM-RP apesentou valores médios significativamente menores. CONCLUSÕES: Obesos apresentam um perfil de secreção pós-prandial de PYY, GLP-1 e GLP-2, distinto dos pacientes submetidos a gastroplastia em Y de Roux. Nos pacientes que recuperam o peso, as concentrações de leptina foram significativamente maiores quando comparadas àquelas dos pacientes que não reganharam, sugerindo provável resistência a ação deste hormônio. Os pacientes SEM-RP apresentaram menor variação do GIP, o que pode estar relacionado a restauração do processo secretório. O GLP-1, GLP-2, PYY e GRELINA não apresentaram correlação com o reganho do peso.Dados abertos - Sucupira - Teses e dissertações (2019)Universidade Federal de São Paulo (UNIFESP)Lopes Filho, Gaspar De Jesus [UNIFESP]Arasaki, Carlos Haruo [UNIFESP]http://lattes.cnpq.br/8299360555227115http://lattes.cnpq.br/3518607824692081http://lattes.cnpq.br/7034900883648145Universidade Federal de São Paulo (UNIFESP)Saboya Sobrinho, Carlos Jose [UNIFESP]2021-01-19T16:32:11Z2021-01-19T16:32:11Z2019-11-28info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersion88 f.application/pdfhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=8166318SABOYA SOBRINHO, Carlos José. Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux. 2019. 88f. Tese (Doutorado em Ciência Cirúrgica Interdisciplinar) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2019.CARLOS JOSÉ SABOYA SOBRINHO-A.pdfhttps://repositorio.unifesp.br/handle/11600/59349porSão Pauloinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-03T00:12:04Zoai:repositorio.unifesp.br/:11600/59349Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-03T00:12:04Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux Evaluation of gastrointestinal hormones and leptin in patients with and without weight regain five years after Roux-en-Y gastric bypass |
title |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux |
spellingShingle |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux Saboya Sobrinho, Carlos Jose [UNIFESP] Bariatric Surgery Weight Regain Gastroinstestinal Hormones Leptin Obesity Gastric Bypass Cirurgia Bariátrica Reganho De Peso Hormônios Gastrointestinais Leptina Obesidade Bypass Gástrico |
title_short |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux |
title_full |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux |
title_fullStr |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux |
title_full_unstemmed |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux |
title_sort |
Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux |
author |
Saboya Sobrinho, Carlos Jose [UNIFESP] |
author_facet |
Saboya Sobrinho, Carlos Jose [UNIFESP] |
author_role |
author |
dc.contributor.none.fl_str_mv |
Lopes Filho, Gaspar De Jesus [UNIFESP] Arasaki, Carlos Haruo [UNIFESP] http://lattes.cnpq.br/8299360555227115 http://lattes.cnpq.br/3518607824692081 http://lattes.cnpq.br/7034900883648145 Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Saboya Sobrinho, Carlos Jose [UNIFESP] |
dc.subject.por.fl_str_mv |
Bariatric Surgery Weight Regain Gastroinstestinal Hormones Leptin Obesity Gastric Bypass Cirurgia Bariátrica Reganho De Peso Hormônios Gastrointestinais Leptina Obesidade Bypass Gástrico |
topic |
Bariatric Surgery Weight Regain Gastroinstestinal Hormones Leptin Obesity Gastric Bypass Cirurgia Bariátrica Reganho De Peso Hormônios Gastrointestinais Leptina Obesidade Bypass Gástrico |
description |
OBJECTIVE: To evaluate and compare the role of gastrointestinal hormones – GHRELIN, peptide YY 3-36 (PYY 3-36), glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-2 (GLP-2) - and LEPTIN in patients with and without weight regain undergoing Roux-en-Y gastric bypass after five years of the surgical procedure. METHODS: This is an observational, cross-sectional study, where 72 individuals divided into 3 paired groups: Group WR (WITH WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass with weight regain; Group WWR (WITHOUT WEIGHT REGAIN): 24 patients undergoing Roux-en-Y gastric bypass without weight regain and Group NO-OP (NON-OPERATED OBESE): 24 obese patients who are candidates for bariatric surgery. Patients with weight regain, defined as the increase of 5kg/m2 in BMI, taking as reference the minimum BMI reached during the postoperative period and the current BMI. The overall patients underwent clinical, biochemical, anthropometric and endoscopic evaluation. Hormone evaluation was performed in four settings – fasting, 30, 60 and 120 minutes - after standard meal intake, considering that the secretion of gastrointestinal hormones is affected by nutrient intake. RESULTS: For GLP-1, GLP-2 and PYY, values in the control group (NO-OP) did not change significantly. In the WR and WWR there was a sharp elevation at 30 minutes followed by a decrease at 60 and 120 minutes, ending with mean values still higher than baseline. Variations in ghrelin were not considered statistically significant. For GIP, the three groups showed similar behavior, with an increase at 30 minutes and a decrease at 60 and 120 minutes; however, in the overall evaluation (baseline period up to 120min), the WWR was the group in which GIP reached its lowest variation compared to baseline, and a statistical difference was found compared to the NO-OP and the WR groups. For leptin, the RW was similar to control, while the WWR showed significantly lower mean values. CONCLUSIONS: Non-operated obese individuals showed a postprandial secretion profile of PYY, GLP-1 and GLP-2, distinct from patients undergoing Roux-en-Y gastric bypass. In patients with weight regain, leptin concentrations were significantly higher when compared to patients without weight regain, thus suggesting a probable resistance to the action of this hormone. Patients without weight regain showed less variation in GIP, which implies a possible relation to the restoration of the secretory process after glucose control. GLP-1, GLP-2, PYY and GHRELIN showed no correlation with weight regain. Further studies should be conducted to better identify the mechanisms responsible for the findings reported by the current investigation, as well as clarifications on other conditions induced by Roux-en-Y gastric bypass. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-11-28 2021-01-19T16:32:11Z 2021-01-19T16:32:11Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=8166318 SABOYA SOBRINHO, Carlos José. Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux. 2019. 88f. Tese (Doutorado em Ciência Cirúrgica Interdisciplinar) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2019. CARLOS JOSÉ SABOYA SOBRINHO-A.pdf https://repositorio.unifesp.br/handle/11600/59349 |
url |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=8166318 https://repositorio.unifesp.br/handle/11600/59349 |
identifier_str_mv |
SABOYA SOBRINHO, Carlos José. Avaliação de hormônios gastrointestinais e leptina em pacientes com e sem reganho do peso após cinco anos da gastroplastia em y de roux. 2019. 88f. Tese (Doutorado em Ciência Cirúrgica Interdisciplinar) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2019. CARLOS JOSÉ SABOYA SOBRINHO-A.pdf |
dc.language.iso.fl_str_mv |
por |
language |
por |
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info:eu-repo/semantics/openAccess |
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openAccess |
dc.format.none.fl_str_mv |
88 f. application/pdf |
dc.coverage.none.fl_str_mv |
São Paulo |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
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Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
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UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268313997410304 |