Endocrine implications of bariatric surgery: a review on the intersection between incretins, bone, and sex hormones

Gastric bypass surgery leads to dramatic weight loss and improvement in insulin resistance to the point of the resolution of type 2 diabetes in a majority of cases. These improvements in insulin sensitivity appear to be weight loss independent and occur immediately after bariatric surgery. The focus of the current review will be to summarize how the physiological changes that have been shown to arise from sustained weight loss after bariatric surgery affect other interrelated endocrine processes such as bone remodeling and improve obesity ‐related hypogonadal dysfunction. AbstractBariatric surgery is now the most widely used intervention for the treatment of human obesity. A large body of literature has demonstrated its efficacy in sustained weight loss and improvement in its associated comorbidities. Here, we review the effect of bariatric surgery in gut hormone physiology, bone remodeling and the reproductive axis. Rapid improvements in insulin release and sensitivity appear to be weight loss independent and occur immediately after surgery. These effects on pancreatic beta cells are mostly due to increased gut hormone secretion due to augmented nutrient delivery to the small intestine. Bone remodeling is also affected by gut hormones. Phenotypic skeletal changes observed in mice deficient in GLP ‐1 or GIP suggest that increased incretins may improve bone density. However, these positive effects may be counterbalanced by the association between weight loss and a reductio...
Source: Physiological Reports - Category: Physiology Authors: Tags: Invited Review Source Type: research

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Source: Revista Clinica Espanola - Category: Internal Medicine Source Type: research
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Source: Molecular and Cellular Endocrinology - Category: Endocrinology Source Type: research
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