{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:33:51Z","timestamp":1792211631779,"version":"4.4.0"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Indroduction<\/jats:title><jats:p>Glucagon-like peptide-1 (GLP-1) is integral to glucose homeostasis, appetite, and reward pathways in the brain, making GLP-1 receptor agonists effective treatments for type 2 diabetes, obesity, and potentially alcohol use disorder (AUD). Although metabolic surgery increases endogenous GLP-1, it is paradoxically associated with a higher risk of AUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Building on cross-sectional research indicating that alcohol consumption decreases endogenous GLP-1 and may contribute to a heightened risk of hypoglycemia post-metabolic surgery, this longitudinal, within-subject study examined whether acute alcohol intake reduced GLP-1 and increased fibroblast growth factor 21 (FGF21)\u2013a liver-derived hormone implicated in glucose regulation and alcohol consumption in animal models \u2013more profoundly after surgery. Seven women were assessed using a randomized, crossover design; they consumed after overnight fast a standardized alcohol-containing beverage or placebo during two separate visits before surgery and repeated these interventions \u223c5 months post-surgery. Blood samples were collected over 3 hours to measure blood alcohol concentration (BAC), and plasma glucose, GLP-1, FGF21, insulin, and C-peptide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Post-surgery, BAC peaked faster and at higher concentrations, and alcohol clearance decreased by \u223c28%\u2013likely reflecting the loss of fat-free mass. However, the acute GLP-1 decrease and profound FGF21 increase following alcohol intake were not magnified in the postoperative period, nor did alcohol-induced reductions in glucose become more pronounced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>These findings suggest that, despite substantial weight loss and improvements in insulin sensitivity, acute alcohol consumption in the fasted state elicits comparable effects on GLP-1, FGF21, and glycemia before and a few months after metabolic surgery. Further studies with larger and more diverse cohorts are warranted to confirm these observations, clarify long-term effects on alcohol metabolism and glycemic control, and inform strategies to mitigate the potential risk of AUD in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>NCT02766322.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1575156","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T05:27:34Z","timestamp":1747891654000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Glucagon-like peptide-1, fibroblast growth factor 21, and other endocrine responses to alcohol ingestion in women before and after metabolic surgery"],"prefix":"10.3389","volume":"16","author":[{"given":"Mariel","family":"Molina-Castro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair","family":"Rowitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Yanina","family":"Pepino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/J.SOARD.2017.11.010","article-title":"Sleeve gastrectomy surgery: when 2 alcoholic drinks are converted to 4","volume":"14","author":"Acevedo","year":"2018","journal-title":"Surg. 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