Zusammenfassung
HINTERGRUND: Gewichtsverlust durch adipositaschirurgische Eingriffe reduziert Begleiterkrankungen adipöser Menschen. Die Umkehr pathologischer Sekretionsmuster appetitregulierender gastrointestinaler Hormone, wie Peptide YY (PYY), könnte zur Verringerung kardiovaskulärer Risikofaktoren beitragen. METHODIK: Bei 42 hochgradig adipösen Patienten (BMI = 45,7 ± 5,3 kg/m2) wurden klinische Untersuchungen und Blutproben zur Bestimmung von PYY, Blutfetten, Durchführung von oralen Glukosetoleranztests und Berechnungen zur Insulinsekretion (HOMA-%B) und -resistenz (HOMA-R, QUICKI) vor und nach 12 Monaten einer Magenband-Operation durchgeführt. RESULTATE: Adipositaschirurgisch induzierter Gewichtsverlust resultierte in Reduktion von Insulinresistenz (p < 0,03) und Plasma-Triglyzeriden (p < 0,01) um 54% und 26%, ohne Änderung der Nüchtern-PYY-Spiegel (16,2 ± 8,7 basal und 15,1 ± 6,3 pmol/l nach 12 Monaten). Vor Intervention korrelierte PYY negativ mit dem Gesamtcholesterin (p = 0,02), war aber weder mit Körpergewicht, Körpermasse oder Bauchumfang assoziiert. Der Verlauf von PYY (ΔPYY) korrelierte aber mit dem Insulinverlauf (ΔNüchtern-Insulin-Spiegel) (r = −0.582, p = 0.02 nach 12 Monaten) und HOMA-B (r = −0.677, p = 0.006 nach 6 und r = −0.660, p = 0.007 nach 12 Monaten). Eine diabetische Stoffwechsellage beeinflusste diese Resultate nicht. ZUSAMMENFASSUNG: Bei Adipositas korreliert PYY mit einem kardiovaskulären Risikofaktor und Markern der Insulinsekretion, aber weder mit Gewichtsreduktion noch mit Körpermasse.
Summary
INTRODUCTION: Surgically induced weight loss results in reduction of comorbidities in severely obese humans. Reversal of abnormal secretion of appetite-regulating gut hormones such as peptide YY (PYY) could be contributing to the improvement of cardiovascular risk factors. METHODS: Severely obese patients (n = 42, BMI = 45.7 ± 5.3 kg/m2) underwent clinical examination and blood sampling for measurement of PYY, plasma lipids, oral glucose tolerance testing and assessment of insulin secretion (HOMA-%B) and action (HOMA-R, QUICKI) before and during 12 months following gastric banding. Comparisons were made at each time point of the study as well as across the total study period. RESULTS: Weight loss after bariatric surgery resulted in improvement of insulin resistance by 54% (p < 0.03) and plasma triglycerides by 26% (p < 0.01) without changes in fasting PYY (16.2 ± 8.7 pmol/l at baseline, 15.1 ± 6.3 pmol/l at 12 months). Fasting PYY correlated negatively with plasma total cholesterol at baseline (p = 0.02) but was not associated with body weight, body mass or abdominal diameter. Individual changes in PYY (ΔPYY) related to changes in insulin (Δfasting insulin) at 12 months (r = −0.582, p = 0.02) and HOMA-B at 6 months (r = −0.677, p = 0.006) and 12 months (r = −0.660, p = 0.007). Diabetic status had no impact on these correlations. DISCUSSION: PYY correlates with a major cardiovascular risk factor and surrogate parameters of insulin secretion but not to weight loss or body mass in severe obesity.
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Hanusch-Enserer, U., Ghatei, M., Cauza, E. et al. Relation of fasting plasma peptide YY to glucose metabolism and cardiovascular risk factors after restrictive bariatric surgery. Wien Klin Wochenschr 119, 291–296 (2007). https://doi.org/10.1007/s00508-007-0776-5
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DOI: https://doi.org/10.1007/s00508-007-0776-5