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Obesity Surgery
Published in: Obesity Surgery 4/2017

01-04-2017 | Original Contributions

Plasma Ghrelin Levels and Weight Regain After Roux-en-Y Gastric Bypass Surgery

Authors: Barham K. Abu Dayyeh, Pichamol Jirapinyo, Christopher C. Thompson

Published in: Obesity Surgery | Issue 4/2017

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Abstract

Purpose

Ghrelin is a gut hormone that induces hunger, gastric acid secretion, and gastrointestinal motility. A number of studies have previously demonstrated a possible correlation between a decrease in ghrelin level and weight loss after Roux-en-Y gastric bypass (RYGB). This study aimed to assess if there was a relationship between ghrelin level and weight regain after RYGB nadir weight had been achieved.

Materials and Methods

Sixty-three consecutive RYGB patients who were referred for an upper endoscopy were enrolled. Weight and responses to the 21-item Three-Factor Eating Questionnaire (TFEQ-R21) were collected. Ghrelin levels were measured. Upper endoscopy was performed to evaluate pouch length and stoma diameter. Multivariate linear regression was performed to assess an association between ghrelin level, TFEQ-R21 score, pouch length, stoma diameter, and percentage of weight regained.

Results

Subjects were 47 ± 10 years old and had a BMI of 38 ± 7.7 kg/m2. Out of 63 patients, 76 % had weight regain (gaining of ≥20 % of maximal weight lost after the RYGB) and 24 % did not. Average pouch length was 44 ± 13 mm, stoma diameter 20 ± 6.6 mm, and ghrelin levels 125 ± 99 ng/ml. Ghrelin level was not associated with weight regain (β = 0.17, p = 0.2). GJ stoma diameter was associated with weight regain (β = 0.39, p < 0.01) and the uncontrolled eating domain of the TFEQ-R21 (β = 0.45, p < 0.01).

Conclusion

Ghrelin levels do not appear to correlate with weight change after RYGB nadir weight has been achieved. A dilated GJ stoma diameter is a risk factor for weight regain and uncontrolled eating behavior after RYGB.
Literature
1.
Lim SS et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systemic analysis for the global burden disease study. Lancet. 2012;380:2224–60.CrossRefPubMedPubMedCentral
2.
3.
Phillips RJ, Powley TL. Gastric volume rather than nutrient content inhibits food intake. Am J Phys. 1996;271:R766–9.
4.
Cummings DE et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med. 2002;346:1623–30.CrossRefPubMed
5.
6.
Cushing CC et al. Longitudinal trends in hedonic hunger after Roux-en-Y gastric bypass in adolescents. Surg Obes Relat Dis. 2014;10:125–30.CrossRefPubMed
7.
Borg CM et al. Progressive rise in gut hormone levels after Roux-en-Y gastric bypass suggests gut adaptation and explains altered satiety. Br J Surg. 2006;93:210–5.CrossRefPubMed
8.
Holdstock C et al. Effect of bariatric surgery on adipose tissue regulatory peptides and growth hormone secretion. Asia Pac J Clin Nutr. 2004;13:S41.
9.
Sjostrom L et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.CrossRefPubMed
10.
Sjostrom L et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed
11.
Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2001;9:228–33.CrossRef
12.
Heneghan HM et al. Influence of pouch and stoma size on weight loss after gastric bypass. Surg Obes Relat Dis. 2012;8:408–15.CrossRefPubMed
13.
Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.CrossRefPubMedPubMedCentral
14.
Shah M, Simha V, Garg A. REVIEW: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91:4223–31.CrossRefPubMed
15.
Ariyasu H et al. Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. J Clin Endocrinol Metab. 2001;86:4753–8.CrossRefPubMed
16.
Schwartz MW et al. Central nervous system control of food intake. Nature. 2000;404:661–71.PubMed
17.
Cummings DE et al. Plasma ghrelin levels and hunger scores in humans initiating meals voluntarily without time- and food-related cues. Am J Physiol Endocrinol Metab. 2004;287:E297–304.CrossRefPubMed
18.
Hanusch-Enserer U et al. Plasma ghrelin in obesity before and after weight loss after laparoscopical adjustable gastric banding. J Clin Endocrinol Metab. 2004;89:3352–8.CrossRefPubMed
19.
Mariani LM et al. Transient increase of plasma ghrelin after laparoscopic adjustable gastric banding in morbid obesity. Horm Metab Res. 2005;37:242–5.CrossRefPubMed
20.
Fruhbeck G et al. The decrease in plasma ghrelin concentrations following bariatric surgery depends on the functional integrity of the fundus. Obes Surg. 2004;14:606–12.CrossRefPubMed
21.
Fruhbeck G et al. Fasting plasma ghrelin concentrations 6 months after gastric bypass are not determined by weight loss or changes in insulinemia. Obes Surg. 2004;14:1208–15.CrossRefPubMed
22.
Cummings DE, Overduin J, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab. 2004;89:2608–15.CrossRefPubMed
23.
Stylopoulos N et al. Changes in serum ghrelin predict weight loss after Roux-en-Y gastric bypass in rats. Surg Endosc. 2005;19:942–6.CrossRefPubMed
24.
Crujeiras AB, Goyenechea E, Abete I, et al. Weight regain after a diet-induced loss is predicted by higher baseline leptin and lower ghrelin plasma levels. J Clin Endocrinol Metab. 2010;95:5037–44.CrossRefPubMed
25.
Garcia JM, Iyer D, Poston WS, et al. Rise of plasma ghrelin with weight loss is not sustained during weight maintenance. Obesity. 2006;14:1716–23.CrossRefPubMed
26.
Soni AC, Conroy MB, Mackey RH, et al. Ghrelin, leptin, adiponectin, and insulin levels and concurrent and future weight change in overweight, post-menopausal women. Menopause. 2011;18:296–301.CrossRefPubMedPubMedCentral
27.
Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365:1597–604.CrossRefPubMed
28.
Santo MA, Riccioppo D, Pajecki D, et al. Weight regain after gastric bypass: influence of gut hormones. Obes Surg. 2016;26:919–25.CrossRefPubMed
29.
Fiegal KM, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307:491–7.CrossRef
30.
Buchwald H, Consensus Conference Panel. Consensus conference statement bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis. 2005;1:371–81.CrossRefPubMed
31.
Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systemic review and meta-analysis. Am J Med. 2009;122:248–56.CrossRefPubMed
Metadata
Title
Plasma Ghrelin Levels and Weight Regain After Roux-en-Y Gastric Bypass Surgery
Authors
Barham K. Abu Dayyeh
Pichamol Jirapinyo
Christopher C. Thompson
Publication date
01-04-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2418-3

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