Roux-en-Y Gastric Bypass restores insulin and gut hormones responses to acute exercise

Abstract

Background The acute exercise-mediated changes in metabolic, immunomodulatory, and gut hormones are blunted by excessive adiposity. We investigated whether bariatric surgery restore the acute responses to exercise on glucose metabolism, gut hormones, and inflammatory markers in women with severe obesity. Methods Thirteen women eligible for bariatric surgery underwent an acute exercise session before and 3 months after surgery. Blood samples were collected at baseline and immediately and 30 minutes after exercise to analyze glucose, insulin, inflammatory markers (INFγ, IL-1β, IL-1ra, TNFα, MCP1, IL-6, IL-8, IL-17A, IL-4, and IL-10), and gut hormones (Ghrelin, GIP, GLP-1, PP, PYY). Results Before surgery, there were no significant changes in post-exercise glucose response (all P > 0.05). Post-surgery, glucose levels decreased immediately and 30 minutes after exercise (both P < 0.05), but glucose AUC remained similar (181.0 vs. 166.8 mg/dL x min^− 1, P > 0.05) between conditions. Insulin response to exercise remained unchanged regardless of surgery (all P > 0.05), but insulin AUC was significantly reduced post-surgery (60.7 vs. 26.3 µU/mL x min^− 1, P = 0.046). No changes occurred in GLP-1 and PYY levels pre-surgery exercise (all P > 0.05); however, both parameters were increased immediately and 30 minutes post-exercise (all P < 0.05) after the surgical intervention. AUC for GLP-1 (2.3 vs. 14.5 pg/mL x min^− 1, P = 0.008) and PYY (9.9 vs. 224.2 pg/mL x min^− 1, P = 0.0004) were increased post-surgery. Surgery did not affect PP or GIP responses to exercise. Both parameters were elevated immediately (before surgery: P = 0.027 and P = 0.002, respectively; after surgery: P = 0.096 and P = 0.002, respectively) and 30 minutes post-exercise (before surgery: P = 0.002 and P < 0.0001, respectively; after surgery: P = 0.0004 and P = 0.054, respectively), regardless of surgery. PP AUC was lower post- (549.6 vs. 261.7 pg/mL x min^− 1, P = 0.046) vs. pre-surgery. No changes were observed for ghrelin levels and inflammatory markers (all P > 0.05). Conclusion Bariatric surgery improves the gut hormone responses to exercise in parallel with enhanced peripheral insulin response.