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World J Gastroenterol. Nov 28, 2014; 20(44): 16649-16664
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16649
Could the improvement of obesity-related co-morbidities depend on modified gut hormones secretion?
Carmine Finelli, Maria Carmela Padula, Giuseppe Martelli, Giovanni Tarantino
Carmine Finelli, Center of Obesity and Eating Disorders, Stella Maris Mediterraneum Foundation, Chiaromonte, 85035 Potenza, Italy
Maria Carmela Padula, Giuseppe Martelli, Department of Science, University of Basilicata, Potenza, 85100 Viale dell’Ateneo Lucano, Italy
Giovanni Tarantino, Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, 80131 Naples, Italy
Giovanni Tarantino, Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale Per Lo Studio E La Cura Dei Tumori “Fondazione Giovanni Pascale”, IRCCS, 83013 Mercogliano (Av), Italy
Author contributions: Finelli C conceived the study; Tarantino G analyzed literature data; Finelli C and Tarantino G equally contributed to drafting the manuscript; Padula MC and Martelli P critically revised the manuscript.
Correspondence to: Giovanni Tarantino, MD, Senior Clinical Investigator, Past Adjunct Professor of Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy. tarantin@unina.it
Telephone: +39-81-7462024 Fax: +39-81-5466152
Received: February 23, 2014
Revised: May 27, 2014
Accepted: June 25, 2014
Published online: November 28, 2014
Processing time: 279 Days and 15.7 Hours
Abstract

Obesity and its associated diseases are a worldwide epidemic disease. Usual weight loss cures - as diets, physical activity, behavior therapy and pharmacotherapy - have been continuously implemented but still have relatively poor long-term success and mainly scarce adherence. Bariatric surgery is to date the most effective long term treatment for morbid obesity and it has been proven to reduce obesity-related co-morbidities, among them nonalcoholic fatty liver disease, and mortality. This article summarizes such variations in gut hormones following the current metabolic surgery procedures. The profile of gut hormonal changes after bariatric surgery represents a strategy for the individuation of the most performing surgical procedures to achieve clinical results. About this topic, experts suggest that the individuation of the crosslink among the gut hormones, microbiome, the obesity and the bariatric surgery could lead to new and more specific therapeutic interventions for severe obesity and its co-morbidities, also non surgical.

Keywords: Obesity; Bariatric surgery; Gut hormones; Nonalcoholic fatty liver disease; Microbiome

Core tip: It is important to emphasize the role of the major peptides released by the enteroendocrine system, which promote satiety and modulate energy homeostasis and utilization, as well as those that control fat absorption and intestinal permeability. Bariatric surgery could be the most effective treatment for obesity and co-morbidities, often within days after surgery, independently of weight loss and it is currently the only therapy available for obesity which results in long-term, sustained weight loss. We hypothesize that gut hormones might play a role in induction and long-term maintenance of weight loss, could determine the improvement of obesity-related co-morbidities and could help to identify new drug targets and improved surgical techniques.