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1 Department of Psychiatry, University of Cincinnati, Reading, Oh, USA
2 Department of Internal Medicine, University of Cincinnati, Cincinnati, Oh, USA
3 Department of Pathology and Laboratory Medicine, University of Cincinnati, Cincinnati, Oh, USA
4 Division of Endocrinology, University of Cincinnati, Cincinnati, Oh, USA
* To whom correspondence should be addressed. E-mail: april.strader{at}uc.edu.
Bariatric surgeries such as gastric bypass result in dramatic and sustained weight loss that is usually attributed to a combination of gastric volume restriction and intestinal malabsorption. However, studies parceling out the contribution of enhanced intestinal stimulation in the absence of these two mechanisms have received little attention. Previous studies have demonstrated that patients that received intestinal bypass or Roux-en Y surgery have increased release of GI hormones. One possible mechanism for this increase is the rapid transit of nutrients into the intestine after eating. To determine whether there is increased secretion of anorectic peptides produced in the distal small intestine when this portion of the gut is given greater exposure to nutrients, we preformed ileal transpositions (IT) in rats. In this procedure an isolated segment of ileum is transposed to the jejunum resulting in an intestinal tract of normal length but an alteration in the normal distribution of endocrine cells along the gut. Rats with ileal transposition lost more weight (p < 0.05) and consumed less food (p < 0.05) than control rats with intestinal transections and re-anastomosis without transposition. Weight loss in the IT rats was not due to malabsorption of nutrients. However, transposition of distal gut to a proximal location caused increased synthesis and release of the anorectic ileal hormones glucagon like peptide-1 (GLP-1) and peptide YY (PYY) (p < 0.01). The association of weight loss with increased release of GLP- 1 and PYY suggests that procedures that promote GI endocrine function can reduce energy intake. These findings support the importance of evaluating the contribution of GI hormones to the weight loss seen with bariatric surgery.
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