Fasting Plasma Ghrelin Concentrations 6 Months after Gastric Bypass are not Determined by Weight Loss or Changes in Insulinemia |
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Authors: | Gema Frühbeck Fernando Rotellar José Luis Hernández-Lizoain M Jesús Gil Javier Gómez-Ambrosi Javier Salvador Javier A Cienfuegos |
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Institution: | (1) Metabolic Research Laboratory and Department of Endocrinology, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain;(2) Department of Surgery, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain;(3) Department of Surgery, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain;(4) Department of Biochemistry, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain;(5) Metabolic Research Laboratory, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain;(6) Department of Endocrinology, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain;(7) Department of Surgery, Clínica Universitaria de Navarra, University of Navarra, Pamplona, Spain |
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Abstract: | Background: Ghrelin is a gastric peptide with potent orexigenic effects. Circulating ghrelin concentrations are increased
in obese subjects, but increase after weight loss. However, in patients undergoing Roux-en-Y gastric bypass (RYGBP), a decrease
in ghrelin levels has been reported. The effect of comparable weight loss induced by either adjustable gastric banding (AGB),
RYGBP or conventional dietary treatment (Conv) on ghrelinemia was studied. Methods: 24 matched obese male patients in whom
similar weight loss had been achieved by either AGB (n=8), RYGBP (n=8) or Conv (n=8) were studied before and 6 months after
treatment start. The independence of ghrelin concentrations from body mass index (BMI) and weight loss was further analyzed
in a group of patients with total gastrectomy (TtGx, n=6). Results: Comparable weight loss after 6 months exerted significantly
different effects on plasma ghrelin concentrations, depending on the procedure applied (AGB: 424.6 ± 32.8 pg/ml; RYGBP: 131.4
± 13.5; Conv: 457.3 ± 18.7; P<0.001). Without significant differences in body weight and BMI, patients who had undergone the RYGBP exhibited a statistically
significant decrease in fasting ghrelin concentrations, while the other two procedures (AGB and Conv) showed a weight loss-induced
increase in ghrelin levels. Despite significant differences in BMI between RYGBP and TtGx patients after 6 months (31.9 ±
2.2 vs 22.0 ± 0.7 kg/m2, respectively; P<0.05), both groups showed similar ghrelin concentrations. Conclusion: The reduction in circulating ghrelin concentrations
in RYGBP patients after 6 months of surgery are not determined by an active weight loss or an improved insulin-sensitivity
but rather depend on the surgically-induced bypass of the ghrelin-producing cell population of the fundus. |
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Keywords: | GHRELIN ADJUSTABLE GASTRIC BANDING ROUX-EN-Y GASTRIC BYPASS GASTROINTESTINAL SIGNALS MORBID OBESITY WEIGHT LOSS |
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