Roux-en-Y Gastric Bypass Improves Insulin Response and Secretion of GLP-1 and PYY in Response to Postprandial Acute Exercise.

BACKGROUND

The acute exercise-mediated changes in metabolic, immunomodulatory, and gut hormones are blunted by excessive adiposity. We investigated whether bariatric surgery improves the acute postprandial exercise response in terms of glucose metabolism, gut hormones, and inflammatory markers in women with severe obesity.

METHODS

Thirteen women (age: 37 ± 7; BMI: 47.6 ± 5.6) underwent an exercise session (resistance training plus aerobic exercise) before and 3 months after surgery. Blood samples were collected at baseline, immediately and 30 min after exercise to analyze glucose, insulin, inflammatory markers, and gut hormones.

RESULTS

Post-surgery, glucose levels decreased immediately (P = 0.0011) and 30 min after exercise (P = 0.0160), but AUC remained similar (181.0 vs. 166.8 mg/dL x min-1, P = 0.1980) between conditions. Insulin response to postprandial exercise did not change after surgery (all P > 0.05), but AUC was reduced post-surgery (60.7 vs. 26.3 µU/mL x min-1, P = 0.0457). No changes occurred in Glucagon-Like Peptide-1 (GLP-1) and Peptide YY (PYY) pre-surgery exercise (all P > 0.05); however, both parameters were increased immediately (P = 0.0180 and P = 0.0020, respectively) and 30 min post-exercise (P = 0.0380 and P = 0.0360, respectively) after surgery. AUC for GLP-1 (2.3 vs. 14.5 pg/mL x min-1, P = 0.0075) and PYY (9.9 vs. 224.2 pg/mL x min-1, P = 0.0004) were increased post-surgery. Surgery did not affect Pancreatic Polypeptide (PP) or Gastric Inhibitory Polypeptide (GIP) responses to postprandial exercise. Both parameters were elevated immediately (all P < 0.05) and 30 min post-exercise (all P < 0.05), regardless of surgery. PP (549.6 vs. 261.7 pg/mL x min-1, P = 0.0457) and GIP (610.6 vs. 429.1 pg/mL x min-1, P = 0.0260) AUC was lower post- vs. pre-surgery. No changes were observed for ghrelin levels and inflammatory markers (all P > 0.05).

CONCLUSIONS

Bariatric surgery improves the secretion of GLP-1 and PYY in response to postprandial acute exercise in parallel with enhanced peripheral insulin response.