The effect of laparoscopic gastric banding surgery on plasma levels of appetite-control, insulinotropic, and digestive hormones

被引:59
作者
Shak, Joshua R. [1 ]
Roper, Jatin [1 ]
Perez-Perez, Guillermo I. [1 ]
Tseng, Chi-hong [2 ]
Francois, Fritz [1 ,5 ]
Gamagaris, Zoi [1 ,3 ]
Patterson, Carlie [3 ]
Weinshel, Elizabeth [1 ,5 ]
Fielding, George A. [4 ]
Ren, Christine [4 ]
Blaser, Martin J. [1 ,5 ]
机构
[1] NYU, Dept Med, Sch Med, New York, NY 10016 USA
[2] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA
[3] Bellevue Hosp Ctr, Dept Med, New York, NY 10016 USA
[4] NYU, Dept Surg, Sch Med, New York, NY 10016 USA
[5] VA NY Harbor Healthcare Syst, New York, NY USA
关键词
obesity; weight loss; bariatric surgery; adjustable gastric banding; ghrelin; leptin; GIP; GLP-1;
D O I
10.1007/s11695-008-9454-6
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background We hypothesized that laparoscopic adjustable gastric banding (LAGB) reduces weight and modulates ghrelin production, but largely spares gastrointestinal endocrine function. To examine this hypothesis, we determined plasma concentrations of appetite-control, insulinotropic, and digestive hormones in relation to LAGB. Methods Twenty-four patients undergoing LAGB were prospectively enrolled. Body mass index (BMI) was measured and blood samples obtained at baseline and 6 and 12 months post-surgery. Plasma concentrations of leptin, acylated and total ghrelin, pancreatic polypeptide (PP), insulin, glucose-dependent insulinotropic peptide (GIP), active glucagon-like peptide-1 (GLP-1), gastrin, and pepsinogens I and II were measured using enzyme-linked immunoassays. Results Median percent excess weight loss (%EWL) over 12 months was 45.7% with median BMI decreasing from 43.2 at baseline to 33.8 at 12 months post-surgery (p < 0.001). Median leptin levels decreased from 19.7 ng/ml at baseline to 6.9 ng/ml at 12 months post-surgery (p < 0.001). In contrast, plasma levels of acylated and total ghrelin, PP, insulin, GIP, GLP-1, gastrin, and pepsinogen I did not change in relation to surgery (p > 0.05). Pepsinogen II levels were significantly lower 6 months after LAGB but returned to baseline levels by 12 months. Conclusions LAGB yielded substantial %EWL and a proportional decrease in plasma leptin. Our results support the hypothesis that LAGB works in part by suppressing the rise in ghrelin that normally accompanies weight loss. Unchanged concentrations of insulinotropic and digestive hormones suggest that gastrointestinal endocrine function is largely maintained in the long term.
引用
收藏
页码:1089 / 1096
页数:8
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