Efeitos Das Hormonas Do Apetite Na Gastrectomia Sleeve

Autores

  • Carlota Medeiros Pacheco Faculdade de Medicina da Universidade de Coimbra, Portugal
  • André Lázaro Faculdade de Medicina da Universidade de Coimbra; Serviço de Cirurgia Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Professor Associado com agregação em Cirurgia Geral, Assistente Hospitalar Graduado de Cirurgia Geral do Centro Hospitalar e Universitário de Coimbra, Portugal
  • José Guilherme Tralhão Faculdade de Medicina da Universidade de Coimbra; Serviço de Cirurgia Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Professor Associado com agregação em Cirurgia Geral, Assistente Hospitalar Graduado de Cirurgia Geral do Centro Hospitalar e Universitário de Coimbra, Portugal; Professor Catedrático da Faculdade Medicina da Universidade de Coimbra, Assistente Graduado Sénior de Cirurgia Geral do Centro Hospitalar e Universitário de Coimbra, Portugal http://orcid.org/0000-0002-5641-6975

DOI:

https://doi.org/10.34635/rpc.959

Palavras-chave:

sleeve gastrectomia, ghrelin, GLP-1, PYY

Resumo

 

A obesidade é uma condição extremamente prevalente na população mundial associada a uma importante morbimortalidade. De modo a evitar ou atrasar a sua evolução e consequentemente complicações, em casos mais severos, deve-se proceder à cirurgia bariátrica como terapêutica de eleição, destacando-se a gastrectomia sleeve, técnica cirúrgica mais comumente realizada. Esta opção terapêutica é a mais eficaz no tratamento da obesidade e complicações a longo prazo, ao promover uma maior e sustentada perda de peso. Como efeito da cirurgia verificam-se alterações significativas na homeostasia da glicose e até mesmo em alguns casos uma remissão da diabetes mellitus. Sabe-se que existem inúmeras hormonas gastrointestinais, nomeadamente a grelina, o glucagon-like peptide 1 e o péptido tirosina-tirosina, que têm sido sugeridas como importantes mediadores das alterações metabólicas no pós-operatório, a nível da regulação do apetite, da perda de peso e até da homeostasia da glicose. Torna-se então fulcral evidenciar as alterações das concentrações destas 3 hormonas resultantes da realização da gastrectomia sleeve, e assim esclarecer o papel e o impacto destas nos efeitos metabólicos pós-operatórios e consequentemente na eficácia da cirurgia. Nesta revisão conclui-se que, após a realização da cirurgia, ocorre uma diminuição dos níveis séricos em jejum e pós-prandiais de grelina e um aumento dos níveis pós-prandiais do glucagon-like peptide 1 e do péptido tirosina-tirosina, de forma significativa, contribuindo assim para o sucesso da gastrectomia sleeve.

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Referências

1. McCarty TR, Jirapinyo P, Thompson CC. Effect of Sleeve Gastrectomy on Ghrelin, GLP-1, PYY, and GIP Gut Hormones: A Systematic Review and Meta-analysis. Ann Surg. 2020 Jul 1;272(1):72–80.
2. Peterli R, Wölnerhanssen B, Peters T, Devaux N, Kern B, Christoffel-Courtin C, et al. Improvement in Glucose Metabolism After Bariatric Surgery: Comparison of Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy. A Prospective Randomized Trial. Annals of Surgery. 2009 Aug;250(2):234–41.
3. Dimitriadis GK, Randeva MS, Miras AD. Potential Hormone Mechanisms of Bariatric Surgery. Vol. 6, Current Obesity Reports. 2017 Sep;6(3):253–65.
4. Papamargaritis D, le Roux CW. Do gut hormones contribute to weight loss and glycaemic outcomes after bariatric surgery? Vol. 13, Nutrients. 2020 Feb 26;13(3):762.
5. Scott WR, Batterham RL. Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2011 Jul;301(1):R15–27.
6. Lampropoulos C, Alexandrides T, Tsochatzis S, Kehagias D, Kehagias I. Are the Changes in Gastrointestinal Hormone Secretion Necessary for the Success of Bariatric Surgery? A Critical Review of the Literature. Obesity Surgery. 2021 Oct;31(10):4575-84.
7. Lopez-Nava G, Negi A, Bautista-Castaño I, Rubio MA, Asokkumar R. Gut and Metabolic Hormones Changes After Endoscopic Sleeve Gastroplasty (ESG) Vs. Laparoscopic Sleeve Gastrectomy (LSG). Obesity Surgery. 2020 Jul 1;30(7):2642–51.
8. Casajoana A, Pujol J, Garcia A, Elvira J, Virgili N, de Oca FJ, et al. Predictive Value of Gut Peptides in T2D Remission: Randomized Controlled Trial Comparing Metabolic Gastric Bypass, Sleeve Gastrectomy and Greater Curvature Plication. Obesity Surgery. 2017 Sep 1;27(9):2235–45.
9. Ionut V, Burch M, Youdim A, Bergman RN. Gastrointestinal hormones and bariatric surgery-induced weight loss. Obesity. 2013 Jun;21(6):1093–103.
10. Meek CL, Lewis HB, Reimann F, Gribble FM, Park AJ. The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones. Vo. 77. Peptides. Elsevier Inc. 2016 Mar;77:28–37.
11. Ramón JM, Salvans S, Crous X, Puig S, Goday A, Benaiges D, et al. Effect of Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy on Glucose and Gut Hormones: A Prospective Randomised Trial. Journal of Gastrointestinal Surgery. 2012 Jun;16(6):1116–22.
12. Yousseif A, Emmanuel J, Karra E, Millet Q, Elkalaawy M, Jenkinson AD, et al. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obesity Surgery. 2014 Feb;24(2):241–52.
13. Peterli R, Steinert RE, Woelnerhanssen B, Peters T, Christoffel-Courtin C, Gass M, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: A randomized, prospective trial. Obesity Surgery. 2012 May;22(5):740–8.
14. Nannipieri M, Baldi S, Mari A, Colligiani D, Guarino D, Camastra S, et al. Roux-en- Y gastric bypass and sleeve gastrectomy: Mechanisms of diabetes remission and role of gut hormones. Journal of Clinical Endocrinology and Metabolism. 2013 Nov 1;98(11):4391–9.
15. Arakawa R, Febres G, Cheng B, Krikhely A, Bessler M, Korner J. Prospective study of gut hormone and metabolic changes after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Vol. 15, PLoS ONE. Public Library of Science; 2020 Jul 20;15(7):e0236133.
16. Yang J, Gao Z, Williams DB, Wang C, Lee S, Zhou X, et al. Effect of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy on fasting gastrointestinal and pancreatic peptide hormones: A prospective nonrandomized trial. Surgery for Obesity and Related Diseases. 2018 Oct 1;14(10):1504–12.
17. Dimitriadis E, Daskalakis M, Kampa M, Peppe A, Papadakis JA, Melissas J. Alterations in gut hormones after laparoscopic sleeve gastrectomy: A prospective

clinical and laboratory investigational study. Annals of Surgery. 2013 Apr;257(4):647–54.
18. Shah S, Shah P, Todkar J, Gagner M, Sonar S, Solav S. Prospective controlled study of effect of laparoscopic sleeve gastrectomy on small bowel transit time and gastric emptying half-time in morbidly obese patients with type 2 diabetes mellitus. Surgery for Obesity and Related Diseases. 2010 Mar 4;6(2):152–7.
19. Tsoli M, Chronaiou A, Kehagias I, Kalfarentzos F, Alexandrides TK. Hormone changes and diabetes resolution after biliopancreatic diversion and laparoscopic sleeve gastrectomy: A comparative prospective study. Surgery for Obesity and Related Diseases. 2013 Sep;9(5):667–77.
20. Benaiges D, Más-Lorenzo A, Goday A, Ramon JM, Chillaran JJ, Pedro-Botet J, et al. Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure? Vol 21. World Journal of Gastroenterology. WJG Press. 2015 Nov 7;21(41):11804–14.
21. Bužga M, Švagera Z, Tomášková H, Hauptman K, Holéczy P. Metabolic Effects of Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication: an 18-Month Prospective, Observational, Open-Label Study. Obesity Surgery. 2017 Dec 3;27(12):3258–66.
22. Basso N, Capoccia D, Rizzello M, Abbatini F, Mariani P, Maglio C, et al. First- phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients: The gastric hypothesis. Surgical Endoscopy. 2011;25(11):3540–50.
23. Farey JE, Preda TC, Fisher OM, Levert-Mignon AJ, Stewart RL, Karsten E, et al. Effect of Laparoscopic Sleeve Gastrectomy on Fasting Gastrointestinal, Pancreatic, and Adipose-Derived Hormones and on Non-Esterified Fatty Acids. Obesity Surgery. 2017 Feb 1;27(2):399–407.
24. Major P, Matłok M, Pędziwiatr M, Migaczewski M, Zub-Pokrowiecka A, Radkowiak D, et al. Changes in levels of selected incretins and appetite-controlling hormones following surgical treatment for morbid obesity. Wideochirurgia I Inne Techniki Maloinwazyjne. 2015 Sep 1;10(3):458–65.

25. Casajoana A, Guerrero-Pérez F, Amador &, Ruiz De Gordejuela G, Admella V, Sorribas M, et al. Role of Gastrointestinal Hormones as a Predictive Factor for Long-Term Diabetes Remission: Randomized Trial Comparing Metabolic Gastric Bypass, Sleeve Gastrectomy, and Greater Curvature Plication. Obesity Surgery. 2021 Apr;31(4):1733-44.
26. Salminen P, Helmio M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic roux-en-y gastric bypass onweight loss at 5 years among patients with morbid obesity the SLEEVEPASS randomized clinical trial. JAMA - Journal of the American Medical Association. 2018 Jan 16;319(3):241–54.
27. Bužga M, Zavadilová V, Holéczy P, Švagera Z, Švorc P, Foltys A, et al. Dietary intake and ghrelin and leptin changes after sleeve gastrectomy. Wideochirurgia I Inne Techniki Maloinwazyjne. 2014 Dec 1;9(4):554–61.
28. Hady HR, Dadan J, Gołaszewski P, Safiejko K. Impact of laparoscopic sleeve gastrectomy on body mass index, ghrelin, insulin and lipid levels in 100 obese patients. Wideochirurgia I Inne Techniki Maloinwazyjne. 2012 Dec;7(4):251–9.
29. Kalinowski P, Paluszkiewicz R, Wróblewski T, Remiszewski P, Grodzicki M, Bartoszewicz Z, et al. Ghrelin, leptin, and glycemic control after sleeve gastrectomy versus Roux-en-Y gastric bypass—results of a randomized clinical trial. Surgery for Obesity and Related Diseases. 2017 Feb 1;13(2):181–8.
30. Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, Gfrerer L, Ludvik B, Zacherl J, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-Year results for weight loss and ghrelin. Obesity Surgery. 2010 May;20(5):535–40.
31. Alamuddin N, Vetter ML, Ahima RS, Hesson L, Ritter S, Minnick A, et al. Changes in Fasting and Prandial Gut and Adiposity Hormones Following Vertical Sleeve Gastrectomy or Roux-en-Y-Gastric Bypass: an 18-Month Prospective Study. Obesity Surgery. 2017 Jun;27(6):1563-72.
32. Nosso G, Griffo E, Cotugno M, Saldalamacchia G, Lupoli R, Pacini G, et al. Comparative Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Glucose Homeostasis and Incretin Hormones in Obese Type 2 Diabetic Patients: A One-Year Prospective Study. Hormone and Metabolic Research. 2016 Jan 20;48(5):312–7.
33. Rigamonti AE, Bini S, Rocco MC, Giardini V, Massimini D, Crippa MG, et al. Post- prandial anorexigenic gut peptide, appetite and glucometabolic responses at different eating rates in obese patients undergoing laparoscopic sleeve gastrectomy. Endocrine. 2017 Jan 1;55(1):113–23.
34. Kehagias I, Spyropoulos C, Karamanakos S, Kalfarentzos F. Efficacy of sleeve gastrectomy as sole procedure in patients with clinically severe obesity (BMI ≤50 kg/m2). Surgery for Obesity and Related Diseases. 2013 May;9(3):363–9.
35. Szewczyk T, Janczak P, Janiak A, Gaszyński T, Modzelewski B. Laparoscopic sleeve gastrectomy - 7 years of own experience. Wideochirurgia I Inne Techniki Maloinwazyjne. 2014 Sep 1;9(3):427–35.
36. Perakakis N, Kokkinos A, Peradze N, Tentolouris N, Ghaly W, Pilitsi E, et al. Circulating levels of gastrointestinal hormones in response to the most common types of bariatric surgery and predictive value for weight loss over one year: Evidence from two independent trials. Metabolism: Clinical and Experimental. 2019 Dec;101:153997.
37. Cutolo PP, Nosso G, Vitolo G, Brancato V, Capaldo B, Angrisani L. Clinical Efficacy of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Gastric Bypass in Obese Type 2 Diabetic Patients: a Retrospective Comparison. Obesity Surgery. 2012 Oct 21;22(10):1535–9.
38. Pucci A, Batterham · R L. Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different. Journal of Endocrinological Investigation. 2019 Feb;42(2):117–28.
39. Nielsen MS, Ritz C, Wewer Albrechtsen NJ, Holst JJ, le Roux CW, Sjödin A. Oxyntomodulin and Glicentin May Predict the Effect of Bariatric Surgery on Food Preferences and Weight Loss. The Journal of Clinical Endocrinology & Metabolism. 2020 Apr 1;105(4):e1064–74.

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2024-08-15

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