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Published in: Obesity Surgery 3/2009

01-03-2009 | Research Article

Plasma Ghrelin Modulation in Gastric Band Operation and Sleeve Gastrectomy

Authors: Yong Wang, Jingang Liu

Published in: Obesity Surgery | Issue 3/2009

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Abstract

Background

Gastric band operation and sleeve gastrectomy are increasingly popular bariatric surgeries for weight loss. The purpose of this study is to investigate the changes in plasma ghrelin levels and hypothalamic ghrelin receptor expression with weight loss achieved through these surgeries.

Methods

Twenty-four high fat diet-induced obese rats were used to investigate the effects of gastric band and sleeve operation on Body Mass Index, fat mass, plasma ghrelin levels, and hypothalamic growth hormone secretagogue receptor 1a (GHS-R 1a) protein expression in hypothalamus. In comparison, data of patients who received laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in our hospital in 2005 were also summarized.

Results

Body weights and fat mass decreased significantly in rats that received operation. Plasma ghrelin concentrations in the sleeve group were 0.4-fold of control rats and about 2-fold of control in the gastric band group. GHS-R1a protein expression in hypothalamus was 1.5-fold in the sleeve group compared with control group, while it was only 0.9-fold in the gastric band group. Clinical data showed that patients in the LSG group lost 60% excess body weights in 2 years follow-up. After operation, fasting plasma ghrelin concentrations in LAGB was significantly higher than the LSG group.

Conclusion

Both LAGB and LSG can decrease patients’ excess body weights and fat mass. Plasma ghrelin levels are down-regulated with LSG operation but up-regulated with LAGB operation. Hypothalamic GHS-R1a expression is elevated in sleeve gastrectomy.
Literature
1.
go back to reference Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782–7.CrossRef Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782–7.CrossRef
2.
go back to reference Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. Jama 2008;299:316–23.PubMed Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. Jama 2008;299:316–23.PubMed
3.
go back to reference Guijarro A, Kirchner H, Meguid MM. Catabolic effects of gastric bypass in a diet-induced obese rat model. Curr Opin Clin Nutr Metab Care 2006;9:423–35.CrossRef Guijarro A, Kirchner H, Meguid MM. Catabolic effects of gastric bypass in a diet-induced obese rat model. Curr Opin Clin Nutr Metab Care 2006;9:423–35.CrossRef
4.
go back to reference Chen CM. Overview of obesity in Mainland China. Obes Rev 2008;9(Suppl 1):14–21.CrossRef Chen CM. Overview of obesity in Mainland China. Obes Rev 2008;9(Suppl 1):14–21.CrossRef
5.
go back to reference Suzuki S, Ramos EJ, Goncalves CG, et al. Changes in GI hormones and their effect on gastric emptying and transit times after Roux-en-Y gastric bypass in rat model. Surgery 2005;138:283–90.CrossRef Suzuki S, Ramos EJ, Goncalves CG, et al. Changes in GI hormones and their effect on gastric emptying and transit times after Roux-en-Y gastric bypass in rat model. Surgery 2005;138:283–90.CrossRef
6.
go back to reference Xu Y, Ramos EJ, Middleton F, et al. Gene expression profiles post Roux-en-Y gastric bypass. Surgery 2004;136:246–52.CrossRef Xu Y, Ramos EJ, Middleton F, et al. Gene expression profiles post Roux-en-Y gastric bypass. Surgery 2004;136:246–52.CrossRef
8.
go back to reference Mokdad AH, Bowman BA, Ford ES, et al. The continuing epidemics of obesity and diabetes in the United States. Jama 2001;286:1195–200.CrossRef Mokdad AH, Bowman BA, Ford ES, et al. The continuing epidemics of obesity and diabetes in the United States. Jama 2001;286:1195–200.CrossRef
9.
go back to reference Badman MK, Flier JS. The gut and energy balance: visceral allies in the obesity wars. Science (New York, NY) 2005;307:1909–14.CrossRef Badman MK, Flier JS. The gut and energy balance: visceral allies in the obesity wars. Science (New York, NY) 2005;307:1909–14.CrossRef
10.
go back to reference Asakawa A, Inui A, Kaga T, et al. Ghrelin is an appetite-stimulatory signal from stomach with structural resemblance to motilin. Gastroenterology 2001;120:337–45.CrossRef Asakawa A, Inui A, Kaga T, et al. Ghrelin is an appetite-stimulatory signal from stomach with structural resemblance to motilin. Gastroenterology 2001;120:337–45.CrossRef
11.
go back to reference Fukuda H, Mizuta Y, Isomoto H, et al. Ghrelin enhances gastric motility through direct stimulation of intrinsic neural pathways and capsaicin-sensitive afferent neurones in rats. Scand J Gastroenterol 2004;39:1209–14.CrossRef Fukuda H, Mizuta Y, Isomoto H, et al. Ghrelin enhances gastric motility through direct stimulation of intrinsic neural pathways and capsaicin-sensitive afferent neurones in rats. Scand J Gastroenterol 2004;39:1209–14.CrossRef
12.
go back to reference Klein S, Fontana L, Young VL, et al. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 2004;350:2549–57.CrossRef Klein S, Fontana L, Young VL, et al. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 2004;350:2549–57.CrossRef
13.
go back to reference Kelley DE. Thermodynamics, liposuction, and metabolism. N Eng J Med 2004;350:2542–44.CrossRef Kelley DE. Thermodynamics, liposuction, and metabolism. N Eng J Med 2004;350:2542–44.CrossRef
14.
go back to reference Kirchner H, Guijarro A, Meguid MM. Is a model useful in exploring the catabolic mechanisms of weight loss after gastric bypass in humans. Curr Opin Clin Nutr Metab Care 2007;10:463–74.CrossRef Kirchner H, Guijarro A, Meguid MM. Is a model useful in exploring the catabolic mechanisms of weight loss after gastric bypass in humans. Curr Opin Clin Nutr Metab Care 2007;10:463–74.CrossRef
15.
go back to reference Hill JO, Wyatt HR, Reed GW, et al. Obesity and the environment: where do we go from here. Science (New York, NY) 2003;299:853–5.CrossRef Hill JO, Wyatt HR, Reed GW, et al. Obesity and the environment: where do we go from here. Science (New York, NY) 2003;299:853–5.CrossRef
16.
17.
go back to reference Pinkney JH, Sjostrom CD, Gale EA. Should surgeons treat diabetes in severely obese people. Lancet 2001;357:1357–9.CrossRef Pinkney JH, Sjostrom CD, Gale EA. Should surgeons treat diabetes in severely obese people. Lancet 2001;357:1357–9.CrossRef
18.
go back to reference Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 2006;20:859–63.CrossRef Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 2006;20:859–63.CrossRef
19.
go back to reference Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg 2006;16:1138–44.CrossRef Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg 2006;16:1138–44.CrossRef
20.
go back to reference Deitel M, Crosby RD, Gagner M. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007. Obesity Surgery 2008. Deitel M, Crosby RD, Gagner M. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007. Obesity Surgery 2008.
21.
go back to reference Subramanian S, Han CY, Chiba T, et al. Dietary cholesterol worsens adipose tissue macrophage accumulation and atherosclerosis in obese LDL receptor-deficient mice. Arterioscler Thromb Vasc Biol 2008;28:685–91.CrossRef Subramanian S, Han CY, Chiba T, et al. Dietary cholesterol worsens adipose tissue macrophage accumulation and atherosclerosis in obese LDL receptor-deficient mice. Arterioscler Thromb Vasc Biol 2008;28:685–91.CrossRef
22.
go back to reference Monteiro MP, Ribeiro AH, Nunes AF, et al. Increase in ghrelin levels after weight loss in obese Zucker rats is prevented by gastric banding. Obes Surg 2007;17:1599–607.CrossRef Monteiro MP, Ribeiro AH, Nunes AF, et al. Increase in ghrelin levels after weight loss in obese Zucker rats is prevented by gastric banding. Obes Surg 2007;17:1599–607.CrossRef
23.
go back to reference Schmitz PG, O’Donnell MP, Kasiske BL, et al. Renal injury in obese Zucker rats: glomerular hemodynamic alterations and effects of enalapril. Am J Physiol 1992;263:F496–502.PubMed Schmitz PG, O’Donnell MP, Kasiske BL, et al. Renal injury in obese Zucker rats: glomerular hemodynamic alterations and effects of enalapril. Am J Physiol 1992;263:F496–502.PubMed
24.
go back to reference Baltasar A, Deitel M, Greenstein RJ. Weight loss reporting. Obes Surg 2008;18:761–2.CrossRef Baltasar A, Deitel M, Greenstein RJ. Weight loss reporting. Obes Surg 2008;18:761–2.CrossRef
25.
go back to reference Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ (Clinical research ed 1998;317:703–13).CrossRef Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ (Clinical research ed 1998;317:703–13).CrossRef
26.
go back to reference Dixon JB, Pories WJ, O’Brien PE, et al. Surgery as an effective early intervention for diabesity: why the reluctance. Diabetes Care 2005;28:472–4.CrossRef Dixon JB, Pories WJ, O’Brien PE, et al. Surgery as an effective early intervention for diabesity: why the reluctance. Diabetes Care 2005;28:472–4.CrossRef
27.
go back to reference Grassi G, Cattaneo BM, Seravalle G, et al. Obesity and the sympathetic nervous system. Blood Pressure 1996;1:43–6.PubMed Grassi G, Cattaneo BM, Seravalle G, et al. Obesity and the sympathetic nervous system. Blood Pressure 1996;1:43–6.PubMed
28.
go back to reference Peterli R, Wolnerhanssen BK, Peters T, et al. Prospective study of a two-stage operative concept in the treatment of morbid obesity: primary lap-band followed if needed by sleeve gastrectomy with duodenal switch. Obes Surg 2007;17:334–40.CrossRef Peterli R, Wolnerhanssen BK, Peters T, et al. Prospective study of a two-stage operative concept in the treatment of morbid obesity: primary lap-band followed if needed by sleeve gastrectomy with duodenal switch. Obes Surg 2007;17:334–40.CrossRef
29.
go back to reference Kotidis EV, Koliakos G, Papavramidis TS, et al. The effect of biliopancreatic diversion with pylorus-preserving sleeve gastrectomy and duodenal switch on fasting serum ghrelin, leptin and adiponectin levels: is there a hormonal contribution to the weight-reducing effect of this procedure. Obes Surg 2006;16:554–9.CrossRef Kotidis EV, Koliakos G, Papavramidis TS, et al. The effect of biliopancreatic diversion with pylorus-preserving sleeve gastrectomy and duodenal switch on fasting serum ghrelin, leptin and adiponectin levels: is there a hormonal contribution to the weight-reducing effect of this procedure. Obes Surg 2006;16:554–9.CrossRef
30.
go back to reference Anand BK, Brobeck JR. Localization of a “feeding center” in the hypothalamus of the rat. Proc Soc Exp Biol Med Soc Exp Biol Med (New York, NY) 1951;77:323–4.CrossRef Anand BK, Brobeck JR. Localization of a “feeding center” in the hypothalamus of the rat. Proc Soc Exp Biol Med Soc Exp Biol Med (New York, NY) 1951;77:323–4.CrossRef
31.
go back to reference Sahu A. Minireview: A hypothalamic role in energy balance with special emphasis on leptin. Endocrinology 2004;145:2613–20.CrossRef Sahu A. Minireview: A hypothalamic role in energy balance with special emphasis on leptin. Endocrinology 2004;145:2613–20.CrossRef
32.
go back to reference Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today 2008;38:481–3.CrossRef Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surg Today 2008;38:481–3.CrossRef
33.
go back to reference Roa PE, Kaidar-Person O, Pinto D, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg 2006;16:1323–6.CrossRef Roa PE, Kaidar-Person O, Pinto D, et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg 2006;16:1323–6.CrossRef
Metadata
Title
Plasma Ghrelin Modulation in Gastric Band Operation and Sleeve Gastrectomy
Authors
Yong Wang
Jingang Liu
Publication date
01-03-2009
Publisher
Springer New York
Published in
Obesity Surgery / Issue 3/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9688-3

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