Ghrelin,Leptin and Insulin Levels after Restrictive Surgery: a 2-Year Follow-up Study |
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Authors: | Jeroen Nijhuis Francois M H van Dielen Wim A Buurman Jan Willem M Greve |
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Institution: | (1) Department of General Surgery, Maastricht University, The Netherlands;(2) Department of General Surgery, University Hospital Maastricht, The Netherlands;(3) Department of General Surgery, Maastricht University, The Netherlands;(4) Department of General Surgery, University Hospital Maastricht, The Netherlands |
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Abstract: | Background: Ghrelin is a recently discovered orexigenic gastric hormone, whose production is induced by lack of food in the
stomach. In morbidly obese individuals, ghrelin levels are low compared to lean persons. During dieting, plasma ghrelin levels
increase, leading to an orexigenic signal, which could explain the lack of success of dieting in morbidly obese individuals.
Morbid obesity is best treated with bariatric surgery, in which gastric bypass is reported to be more effective than restrictive
surgery. A possible explanation could be the difference in plasma ghrelin levels after both operations for bariatric surgery.
In this study, plasma ghrelin levels were investigated during a 2-year follow-up. Methods: 17 morbidly obese patients received
gastric restrictive surgery. Plasma ghrelin, leptin and insulin levels were evaluated preoperatively and 1 year and 2 years
postoperatively. Results: BMI decreased from 47.5 ± 6.2 kg/m2 to 33.2 ± 5.8 kg/m2 (P <0.001). Plasma ghrelin levels were significantly increased 1 year (P <0.05) and 2 years (P <0.02) postoperatively. Fasting plasma leptin and insulin levels were significantly lower at 2 years after surgery (P <0.001). Conclusion: After gastric restrictive surgery, ghrelin levels increased, in contrast to the reported fall in ghrelin
levels after gastric bypass. This difference in ghrelin levels between these operations may be the k ey to understanding the
superiority of gastric bypass in sustaining weight loss compared with restrictive surgery. |
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Keywords: | GHRELIN LEPTIN MORBID OBESITY VERTICAL BANDED GASTROPLASTY LAPAROSCOPIC GASTRIC BANDING BARIATRIC SURGERY WEIGHT LOSS |
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