Mechanisms of Bariatric Surgery, Dallas


Bariatric Surgery, Dallas historically was classified as ‘restrictive’ (laparoscopic adjustable gastric band (LAGB) and laparoscopic sleeve gastrectomy (LSG), ‘malabsorptive’ (biliopancreatic diversion with duodenal switch (BPD-DS), or a combination of both (Roux-en-Y gastric bypass (RYGB).

Gastric Hormones

Ghrelin is secreted from X/A-like cells in the fundus. It is the only known orexigenic (appetite stimulant) gut hormone. Its levels are highest in the fasted state, and decrease postprandially.
 Bariatric surgeries have distinct effects on ghrelin secretion. LSG and RYGB are associated with decreased ghrelin levels, while LAGB is associated with increased ghrelin levels. As such, the association between ghrelin levels and weight loss is varied and further study is needed.

Small Intestinal Hormones

Incretins are a class of gut hormones that include glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1). GIP is secreted postprandially from K cells in the duodenum and jejunum, and GLP-1 from L cells in the terminal ileum.
To date, it has been widely believed that GIP and GLP-1 are important factors that contribute to both weight loss and improvement in glycemic control after bariatric Surgery, Dallas.16

Bile Acids

Bile acids, particularly secondary bile acids, have been shown to induce incretins secretion, which lead to increased insulin and decreased glucose levels.
 Increased BA concentrations have been shown to associate with higher GLP-1 and GIP levels, which contribute to improvement in glycemic control. The role of bile acids in LAGB and LSG are less clear.

Gut Microbiota

It has been proposed that changes in intestinal flora may be associated with metabolic improvement after bariatric Surgery, Dallas. Increased prevalence of Bacteroidetes leads to increased conversion of primary to secondary bile acids via 7α-hydroxylase leading to greater GIP and GLP-1 release.


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