Hormonal mechanisms of weight loss and diabetes resolution after bariatric surgery

Surgery for Obesity and Related Diseases

Volumn 1, Issue 3, 2005, Pages 358-368

  Cummings, David E ^a   Overduin, Joost ^a   Shannon, Michael H ^a   Foster Schubert, Karen E ^a  

^a UNIVERSITY OF WASHINGTON   (United States)

Author keywords

Bariatric surgery; Gastric bypass; Ghrelin; Glucagon like peptide 1; Peptide YY

Indexed keywords

CARBOHYDRATE; GASTROINTESTINAL HORMONE; GHRELIN; GLUCAGON LIKE PEPTIDE 1; GLUCOSE; OXYNTOMODULIN; PEPTIDE YY;

BARIATRIC SURGERY; CONDITIONING; DIABETES MELLITUS; ENDOCRINE FUNCTION; FOOD INTAKE; GLUCOSE TOLERANCE; HORMONE RELEASE; HUMAN; ILEUM; INGESTION; LONGITUDINAL STUDY; MALABSORPTION; MEAL; MEDICAL RESEARCH; NUTRIENT; POSTGASTRECTOMY SYNDROME; PRIORITY JOURNAL; PROTEIN SECRETION; REVIEW; ROUX Y ANASTOMOSIS; SATIETY; STOMACH BYPASS; WEIGHT REDUCTION;

BARIATRIC SURGERY; DIABETES MELLITUS; GLUCAGON-LIKE PEPTIDE 1; GROWTH HORMONE; HUMANS; OBESITY, MORBID; PEPTIDE HORMONES; PEPTIDE YY; PROGNOSIS; WEIGHT LOSS;

EID: 33644500317     PISSN: 15507289     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.soard.2005.03.208     Document Type: Review

References (131)

1. Flegal K.M., Carroll M.D., and Ogden C.L. Prevalence and trends in obesity among US adults, 1999-2000. JAMA 288 (2002) 1723-1727
2. Mokdad A.H., Ford E.S., Bowman B.A., et al. Prevalance of obesity, diabetes, and obesity-related risk factors, 2001. JAMA 289 (2003) 76-79
3. Troiano R.P., Flegal K.M., Kuczmarski R.J., et al. Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med 149 (1995) 1085-1091
4. Deitel M. Overweight and obesity worldwide now estimated to involve 1.7 million people. Obes Surg 13 (2003) 329-330
5. Kopelman P.G. Obesity as a medical problem. Nature 404 (2000) 635-643
6. Friedrich M.J. Epidemic of obesity expands its spread to developing countries. JAMA 287 (2002) 1382-1386
7. Manson J.E., Willet W.C., Stampfer M.J., et al. Body weight and mortality among women. N Engl J Med 333 (1995) 677-685
8. Calle E., Thun M., Petrelli J., et al. Body mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med 341 (1999) 1097-1105
9. Yanovski S.Z., and Yanovski J.A. Obesity. N Engl J Med 346 (2002) 591-602
10. Bray G.A., and Tartaglia L.A. Medicinal strategies in the treatment of obesity. Nature 404 (2000) 672-677
11. McTigue K.M., Harris R., Hemphill B., et al. Screening and interventions for obesity in adults. Summary of the evidence for the U.S. Prevention Services Task Force. Ann Intern Med 139 (2003) 933-949
12. Safer D.J. Diet, behavior modification, and exercise. A review of obesity treatments from a long-term perspective. South Med J 84 (1991) 1470-1474
13. Neel J.V. Diabetes mellitus. A "thrifty" genotype rendered detrimental by "progress?". Am J Hum Gen 14 (1962) 353-362
14. Cummings D.E., and Schwartz M.W. Genetics and pathophysiology of human obesity. Annu Rev Med 54 (2003) 453-471
15. Schwartz M.W., Woods S.C., Porte D., et al. Central nervous system control of food intake. Nature 404 (2000) 661-671
16. Brolin R.E. Bariatric surgery and long-term control of morbid obesity. JAMA 288 (2002) 2793-2796
17. Mun E.C., Blackburn G.L., and Matthews J.B. Current status of medical and surgical therapy for obesity. Gastroenterology 120 (2001) 669-681
18. Pories W.J., Swanson M.S., MacDonald K.G., et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 222 (1995) 339-352
19. Cummings D.E., Overduin J., and Foster-Schubert K.E. Gastric bypass for obesity. Mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab 89 (2004) 2608-2615
20. Sjostrom L., Lindroos A.K., Peltonen M., et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. New Engl J Med 351 (2004) 2683-2693
21. Buchwald H., Avidor Y., Braunwald E., et al. Bariatric surgery. A systematic review and meta-analysis. JAMA 292 (2004) 1724-1737
22. Schauer P.R., Burguera B., Ikramuddin S., et al. Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus. Ann Surg 238 (2003) 467-485
23. Sugerman H.J., Wolfe L.G., Sica D.A., et al. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg 237 (2003) 751-758
24. Wittgrove A.C., and Clark G.W. Laparoscopic gastric bypass, Roux-en-Y, 500 patients. Technique and results, with 3- to 60-month follow-up. Obes Surg 10 (2000) 233-239
25. Schauer P.R., Ikramuddin S., Gourash W., et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 232 (2000) 515-529
26. Pories W.J. Diabetes. The evolution of a new paradigm. Ann Surg 239 (2004) 12-13
27. Steinbrook M.D. Surgery for severe obesity. New Engl J Med 350 (2004) 1075-1079
28. National Institutes of Health Consensus Development Conference Panel. Gastrointestinal surgery for severe obesity. Ann Intern Med 1191;115:956-61.
29. Payne J.H., and DeWind L.T. Surgical treatment of obesity. Am J Surg 118 (1969) 141-147
30. Pace W.G., Martin E.W., Tetrick T., et al. Gastric partitioning for morbid obesity. Ann Surg 190 (1979) 392-400
31. Mason E.E. Vertical banded gastroplasty for obesity. Arch Surg 117 (1982) 701-706
32. Balsiger B.M., Poggio J.L., Mai J., et al. Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity. J Gastrointest Surg 4 (2000) 598-605
33. Nightengale M.L., Sarr M.G., Kelly K.A., et al. Prospective evaluation of vertical banded gastroplasty as the primary operation for morbid obesity. Mayo Clin Proc 67 (1991) 304-305
34. Howard L., Malone M., Michalek A., et al. Gastric bypass and vertical banded gastroplasty. A prospective randomized comparison and 5-year follow-up. Obes Surg 5 (1995) 55-60
35. Sugerman H.J., Starkey J., and Birkenhauer R. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters. Ann Surg 205 (1987) 613-624
36. Naslund I. A prospective randomized comparison of gastric bypass and gastroplasty. Acta Chir Scand 152 (1986) 681-689
37. Cummings D.E., and Shannon M.H. Roles for ghrelin in the regulation of appetite and body weight. Arch Surg 138 (2003) 389-396
38. Jones Jr. K.B. Experience with the Roux-en-Y gastric bypass, and commentary on current trends. Obes Surg 10 (2000) 183-185
39. Bo O., and Modalsli O. Gastric banding, a surgical method of treating morbid obesity. Preliminary report. Int J Obes 7 (1983) 493-499
40. Kuzmak L. Stoma adjustable silicone gastric banding. Prob Gen Surg 9 (1992) 298-317
41. Mason E.E. Gastric bypass. Ann Surg 170 (1969) 329-339
42. Must A., Spadano J., Coakley E.H., et al. The disease burden associated with overweight and obesity. JAMA 282 (1999) 1523-1529
43. Trostler N., Mann A., Zilberbush N., et al. Weight loss and food intake 18 months following vertical banded gastroplasty or gastric bypass for severe obesity. Obes Surg 5 (1995) 39-51
44. Halmi K.A., Mason E., Falk J.R., et al. Appetitive behavior after gastric bypass for obesity. Int J Obes 5 (1981) 457-464
45. Kenler H.A., Brolin R.E., and Cody R.P. Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass. Am J Clin Nutr 52 (1990) 87-92
46. Xu Y., Ohinata K., Meguid M.M., et al. Gastric bypass model in the obese rat to study metabolic mechanisms of weight loss. J Surg Res 107 (2002) 56-63
47. Sugerman H.J. Morbid obesity. In: Greenfield L.J. (Ed). Surgery. Scientific principles and practice (1993), Lippincott, Philadelphia 702-708
48. Biertho L., Steffen R., Ricklin T., et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding. A comparative study of 1200 cases. J Am Coll Surg 197 (2003) 536-544
49. Brolin R.E., LaMarca L.B., Kenler H.A., et al. Malabsorptive gastric bypass in patients with superobesity. J Gastrointest Surg 6 (2002) 195-205
50. Le Roux C.W., and Bloom S.R. Why do patients lose weight after Roux-en-Y gastric bypass?. J Clin Endocrinol Metab 90 (2005) 591-592
51. Friedman H.I., Chandler J.G., Peck C.C., et al. Alterations in intestinal structure, fat absorption and body weight after intestinal bypass for morbid obesity. Surg Gynecol Obstet 146 (1978) 757-767
52. Faraj M., Jones P., Sniderman A.D., et al. Enhanced dietary fat clearance in postobese women. J Lipid Res 42 (2001) 571-580
53. MacLean L.D., Rhode B.M., and Nohr C.W. Long- or short-limb gastric bypass?. J Gastrointest Surg 5 (2001) 525-530
54. Naslund I. Gastric bypass versus gastroplasty. A prospective study of differences in two surgical procedures for morbid obesity. Acta Chir Scand Suppl 536 (1987) 44-49
55. MacLean L.D., Rhode B.M., and Nohr C.W. Late outcome of isolated gastric bypass. Ann Surg 231 (2000) 524-528
56. Griffen W.O., Young V.L., and Stevenson C.C. A prospective comparison of gastric and jejunoileal bypass for morbid obesity. Ann Surg 186 (1997) 500-511
57. Mason E.E., Printen K.J., Blommers T.J., et al. Gastric bypass for obesity after ten years experience. Int J Obes 2 (1978) 197-206
58. Mallory G.N., Macgregor A.M., and Rand C.S. The influence of dumping on weight loss after gastric restrictive surgery for morbid obesity. Obes Surg 6 (1996) 474-478
59. Rand C.S., Macgregor A.M., and Hankins G.C. Eating behavior after gastric bypass surgery for obesity. South Med J 80 (1987) 961-964
60. Hafner R.J., Watts J.M., and Rogers J. Quality of life after gastric bypass for morbid obesity. Int J Obes 15 (1991) 555-560
61. Hickey M.S., Pories W.J., MacDonald Jr. K.G., et al. A new paradigm for type 2 diabetes mellitus. Could it be a disease of the foregut?. Ann Surg 227 (1998) 637-644
62. Stoeckli R., Chanda R., Langer I., et al. Changes of body weight and plasma ghrelin levels after gastric banding and gastric bypass. Obes Res 12 (2004) 346-350
63. Kellum J.M., Kuemmerle J.F., O'Dorisio T.M., et al. Gastrointestinal hormone responses to meals before and after gastric bypass and vertical banded gastroplasty. Ann Surg 211 (1990) 763-770
64. Pappas T.N. Physiological satiety implications of gastrointestinal antiobesity surgery. Am J Clin Nutr 55 (1992) 571S-572S
65. Cummings D.E., Weigle D.S., Frayo R.S., et al. Human plasma ghrelin levels after diet-induced weight loss and gastric bypass surgery. New Engl J Med 346 (2002) 1623-1630
66. Kojima M., Hosoda H., Date Y., et al. Ghrelin is a growth hormone-releasing acylated peptide from stomach. Nature 402 (1999) 656-660
67. Tschop M., Smiley D.L., and Heiman M.L. Ghrelin induces adiposity in rodents. Nature 407 (2000) 908-913
68. Nakazato M., Murakami N., Date Y., et al. A role for ghrelin in the central regulation of feeding. Nature 409 (2001) 194-198
69. Wren A.M., Small C.J., Ward H.L., et al. The novel hypothalamic peptide ghrelin stimulates food intake and growth hormone secretion. Endocrinology 141 (2000) 4325-4328
70. Cummings D.E., Purnell J.Q., Frayo R.S., et al. A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes 50 (2001) 1714-1719
71. Cummings D.E., Frayo R.S., Marmonier C., et al. Plasma ghrelin levels and hunger scores in humans initiating meals voluntarily without time- and food-related cues. Am J Physiol Endocrinol Metab 287 (2004) E297-E304
72. Cummings D.E., Foster-Schubert K.E., and Overduin J. Ghrelin and energy balance. Focus on current controversies. Curr Drug Targets 6 (2005) 153-169
73. McLaughlin T., Abbasi F., Lamendola C., et al. Plasma ghrelin concentrations are decreased in insulin-resistant obese adults relative to equally obese insulin-sensitive controls. J Clin Endocrinol Metab 89 (2004) 1630-1635
74. Ariyasu H., Takaya K., Tagami T., et al. Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. J Clin Endocrinol Metab 86 (2001) 4753-4758
75. Geloneze B., Tambascia M.A., Pilla V.F., et al. Ghrelin, a gut-brain hormone. Effect of gastric bypass surgery. Obes Surg 13 (2003) 17-22
76. Fruhbeck G., Caballero A.D., and Gil M.J. Fundus functionality and ghrelin concentrations after bariatric surgery. New Engl J Med 350 (2004) 308-309
77. Lin E., Gletsu N., Fugate K., et al. The effects of gastric surgery on systemic ghrelin levels in the morbidly obese. Arch Surg 139 (2004) 780-784
78. Couce M., Cottam D., Esplen J., et al. Central vs. peripheral ghrelin. Impact on human obesity. Obes Res 11 suppl (2003) A35
79. Morinigo R., Casamitjana R., Moize V., et al. Short-term effects of gastric bypass surgery on circulating ghrelin levels. Obes Res 12 (2004) 1108-1116
80. Tritos N.A., Mun E., Bertkau A., et al. Serum ghrelin levels in response to glucose load in obese subjects post-gastric bypass surgery. Obes Res 11 (2003) 919-924
81. Leonetti F., Silecchia G., Iacobellis G., et al. Different plasma ghrelin levels after laparoscopic gastric bypass and adjustable gastric banding in morbidly obese subjects. J Clin Endocrinol Metab 88 (2003) 4227-4231
82. Korner J., Bessler M., Cirilo L.J., et al. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, and insulin. J Clin Endocrinol Metab 90 (2005) 359-365
83. Faraj M., Havel P.J., Phelis S., et al. Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab 88 (2003) 1594-1602
84. Vidal J., Morinigo R., Casamitjana R., et al. Short-term effects of gastric bypass on circulating ghrelin levels. Obes Res 11 suppl (2003) A9
85. Copeland P., Davis P., and Kaplan L. Weight loss after gastric bypass is associated with decreased plasma gastric inhibitory polypeptide without a significant change in circulating ghrelin. Obes Res 11 suppl (2003) A17
86. Holdstock C., Engstrom B.E., Obrvall M., et al. Ghrelin and adipose tissue regulatory peptides. Effect of gastric bypass surgery in obese humans. J Clin Endocrinol Metab 88 (2003) 3177-3183
87. Belchetz P.E., Plant T.M., Nakai Y., et al. Hypophysial responses to continuous and intermittent delivery of hypothalamic gonadotropin-releasing hormone. Science 202 (1978) 631-633
88. Rittmaster R.S., Loriaux D.L., and Merriam G.R. Effect of continuous somatostatin and growth hormone-releasing hormone (GHRH) infusions on the subsequent growth hormone (GH) response to GHRH: Evidence for somatotroph desensitization independent of GH pool depletion. Neuroendocrinology 45 (1987) 118-122
89. Cummings D.E., and Shannon M.H. Ghrelin and gastric bypass: Is there a hormonal contribution to surgical weight loss?. J Clin Endocrinol Metab 88 (2003) 2999-3002
90. Williams D.L., Cummings D.E., Grill H.J., et al. Meal-related ghrelin suppression requires postgastric feedback. Endocrinology 144 (2003) 2765-2767
91. Overduin J., Frayo R.S., Grill H.J., et al. Role of the duodenum and macronutrient type in ghrelin regulation. Endocrinology 146 (2005) 845-850
92. Williams D.L., Grill H.J., Cummings D.E., et al. Vagotomy dissociates short- and long-term controls of circulating ghrelin. Endocrinology 144 (2003) 5184-5187
93. Kral J.G., Gortz L., Hermansson G., et al. Gastroplasty for obesity. Long-term weight loss improved by vagotomy. World J Surg 17 (1993) 75-79
94. Strader A.D., Vahl T.P., Jandacek R.J., et al. Weight loss through ileal transposition is accompanied by increased ileal hormone secretion and synthesis in rats. Am J Physiol Endocrinol Metab 288 (2005) E447-E453
95. Drucker D.J. Enhancing incretin action for the treatment of type 2 diabetes. Diabetes Care 26 (2003) 2929-2940
96. Batterham R.L., Cowley M.A., Small C.J., et al. Gut hormone PYY(3-36) physiologically inhibits food intake. Nature 418 (2002) 650-654
97. Batterham R.L., Cohen M.A., Ellis S.M., et al. Inhibition of food intake in obese subjects by peptide YY3-36. N Engl J Med 349 (2003) 941-948
98. Deacon C.F. Therapeutic strategies based on glucagon-like peptide 1. Diabetes 53 (2004) 2181-2189
99. Cohen M.A., Ellis S.M., Le Roux C.W., et al. Oxyntomodulin suppresses appetite and reduces food intake in humans. J Clin Endocrinol Metab 88 (2003) 4696-4701
100. Gutzwiller J.P., Goke B., Drewe J., et al. Glucagon-like peptide-1. A potent regulator of food intake in humans. Gut 44 (1999) 81-86
101. Adrian T.E., Ferri G.L., Bacarese-Hamilton A.J., et al. Human distribution and release of a putative new gut hormone, peptide YY. Gastroenterology 89 (1985) 1070-1077
102. Naslund E., Backman L., Holst J.J., et al. Importance of small bowel peptides for the improved glucose metabolism 20 years after jejunoileal bypass for obesity. Obes Surg 8 (1998) 253-260
103. Naslund E., Gryback P., Backman L., et al. Distal small bowel hormones. Correlation with fasting antroduodenal motility and gastric emptying. Dig Dis Sci 43 (1998) 945-952
104. Naslund E., Gryback P., Hellstrom P.M., et al. Gastrointestinal hormones and gastric emptying 20 years after jejunoileal bypass for massive obesity. Int J Obes Relat Metab Disord 21 (1997) 387-392
105. Sorensen T.I., Lauritsen K.B., Holst J.J., et al. Gut and pancreatic hormones after jejunoileal bypass with 3:1 or 1:3 jejunoileal ratio. Digestion 26 (1983) 137-145
106. Sarson D.L., Scopinaro N., and Bloom S.R. Gut hormone changes after jejunoileal (JIB) or biliopancreatic (BPB) bypass surgery for morbid obesity. Int J Obes 5 (1981) 471-480
107. Atkinson R.L., and Brent E.L. Appetite-suppressant activity in plasma of rats after intestinal bypass surgery. Am J Physiol 243 (1982) R60-R64
108. Andrews N.J., and Irving M.H. Human gut hormone profiles in patients with short bowel syndrome. Dig Dis Sci 37 (1992) 729-732
109. Adrian T.E., Savage A.P., Fuessl H.S., et al. Release of peptide YY (PYY) after resection of small bowel, colon, or pancreas in man. Surgery 101 (1987) 715-719
110. Le Roux CW, Aylwin SJB, Coyle F, et al. Meal-stimulated release of the putative satiety hormone PYY in severe obesity and following gastric bypass surgery. Program of the 85th Annual Meeting of the Endocrine Society, Philadelphia, PA, 2003, p. 105 [abstract OR33-2].
111. Meryn S., Stein D., and Straus E.W. Pancreatic polypeptide, pancreatic glucagon, and enteroglucagon in morbid obesity and following gastric bypass operation. Int J Obes 10 (1986) 37-42
112. Long S.D., O'Brien K., MacDonald Jr. K.G., et al. Weight loss in severely obese subjects prevents the progression of impaired glucose tolerance to type II diabetes. A longitudinal interventional study. Diabetes Care 17 (1994) 372-375
113. Pender C., Goldfine I.D., Tanner C.J., et al. Muscle insulin receptor concentrations in obese patients post-bariatric surgery. Relationship to hyperinsulinemia. Int J Obes Relat Metab Disord 28 (2004) 363-369
114. Gray R.E., Tanner C.J., Pories W.J., et al. Effect of weight loss on muscle lipid content in morbidly obese subjects. Am J Physiol Endocrinol Metab 284 (2003) E726-E732
115. Houmard J.A., Tanner C.J., Yu C., et al. Effect of weight loss on insulin sensitivity and intramuscular long-chain fatty acyl-CoAs in morbidly obese subjects. Diabetes 51 (2002) 2959-2963
116. Friedman J.E., Dohm G.L., Leggett-Frazier N., et al. Restoration of insulin responsiveness in skeletal muscle of morbidly obese patients after weight loss. Effect on muscle glucose transport and glucose transporter GLUT4. J Clin Invest 89 (1992) 701-705
117. Murata M., Okimura Y., Iida K., et al. Ghrelin modulates the downstream molecules of insulin signaling in hepatoma cells. J Biol Chem 277 (2002) 5667-5674
118. Broglio F., Arvat E., Benso A., et al. Ghrelin, a natural GH secretagogue produced by the stomach, induces hyperglycemia and reduces insulin secretion in humans. J Clin Endocrinol Metab 86 (2001) 5083-5086
119. Svensson J., Lonn L., Jansson J.O., et al. Two-month treatment of obese subjects with the oral growth hormone (GH) secretagogue MK-677 increases GH secretion, fat-free mass, and energy expenditure. J Clin Endocrinol Metab 83 (1998) 362-369
120. Drucker D.J. Glucagon-like peptide-1 and the islet beta cell. Augmentation of cell proliferation and inhibition of apoptosis. Endocrinology 144 (2003) 5145-5148
121. Zander M., Madsbad S., Madsen J.L., et al. Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and beta-cell function in type 2 diabetes. A parallel-group study. Lancet 359 (2002) 824-830
122. Muscelli E., Mingrone G., Camastra S., et al. Differential effect of weight loss on insulin resistance in surgically treated obese patients. Am J Med 118 (2005) 51-57
123. Koopmans H.S., Ferri G.L., Sarson D.L., et al. The effects of ileal transposition and jejunoileal bypass on food intake and GI hormone levels in rats. Physiol Behav 33 (1984) 601-609
124. Ueno T., Shibata C., Naito H., et al. Ileojejunal transposition delays gastric emptying and decreases fecal water content in dogs with total colectomy. Dis Colon Rectum 45 (2002) 109-116
125. Ohtani N., Sasaki I., Naito H., et al. Effect of ileojejunal transposition of gastrointestinal motility, gastric emptying, and small intestinal transit in dogs. J Gastrointest Surg 3 (1999) 516-523
126. Mason E.E. Ileal transposition and enteroglucagon/GLP-1 in obesity (and diabetic?) surgery. Obes Surg 9 (1999) 223-228
127. Greenway S.E., Greenway F.L., and Klein S. Effects of obesity surgery on non-insulin-dependent diabetes mellitus. Arch Surg 137 (2002) 1109-1117
128. Rubino F, Gagner M. Potential of surgery for curing type 2 diabetes mellitus. Ann Surg 236:554-9.
129. Scopinaro N, Adami GF, Marinari GM, et al. Biliopancreatic diversion. World J Surg 22:936-46.
130. Rubino F., and Marescaux J. Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes. A new perspective for an old disease. Ann Surg 239 (2004) 1-11
131. Rubino F., Zizzari P., Tomasetto C., et al. The role of the small bowel in the regulation of circulating ghrelin levels and food intake in the obese Zucker rat. Endocrinology 146 (2004) 1745-1751