Transient Increase of Plasma Ghrelin after Laparoscopic Adjustable Gastric Banding in Morbid Obesity

L. M. Mariani; A. Fusco; M. Turriziani; A. Veneziani; M. A. Marini; A. de Lorenzo; A. Bertoli

doi:10.1055/s-2005-861410

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2005; 37(4): 242-245
DOI: 10.1055/s-2005-861410

Original Clinical

Transient Increase of Plasma Ghrelin after Laparoscopic Adjustable Gastric Banding in Morbid Obesity

L. M. Mariani¹ , A. Fusco¹ , M. Turriziani¹ , A. Veneziani³ , M. A. Marini¹ , A. de Lorenzo² , A. Bertoli¹

¹ Department of Internal Medicine, Tor Vergata University of Rome, Italy
² Department of Neuroscience, Tor Vergata University of Rome, Italy
³ Department of Surgery, Catholic University of Rome, Italy

Abstract

Ghrelin is a peptide hormone with orexigenic properties that is produced by the stomach. Ghrelin and leptin are thought to be the main regulators of appetite and body weight. The present study was aimed at evaluating the effect of weight reduction after laparoscopic adjustable gastric banding (LAGB) on metabolic parameters and energy balance regulatory peptides. Patients were evaluated before and 6, 12, 24 or 36 months after the procedure, and a blood sample was obtained. Ghrelin rose 6 and 12 months after LABG, and then returned to near-baseline levels. In our study, the correlation between ghrelin and BMI was weak, but a strong significant correlation was maintained between leptin and BMI. We conclude that ghrelin is mainly stimulated by the negative caloric balance, and hypothesize that ghrelin is involved in maintaining a stable body weight, while leptin signals the body energy store; both hormones together are part of a more complex feedback mechanism.

Key words

Ghrelin - Leptin - Obesity - LAGB

Full Text

References

1 Cummings D E, Shannon M H. Roles for ghrelin in the regulation of appetite and body weight. Archives of Surgery. 2003; 138 389-396
2 Tolle V, Kadem M, Bluet-Pajot M T, Frere D, Foulon C, Bossu C. et al . Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally thin women. Journal of Clinical Endocrinology and Metabolism. 2003; 88 109-116
3 Tschöp M, Weyer C P, Tataranni P A, Devanarayan V, Ravussin E, Heiman M L. Circulating Ghrelin Levels Are Decreased in Human Obesity. Diabetes. 2001; 50 707-709
4 Cummings D E, Weigle D S, Frayo R S, Breen P A, Ma M K, Dellinger E P. et al . Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. New England Journal of Medicine. 2002; 346 1623-1630
5 Faraj M, Havel P J, Phelis S, Blank D, Sniderman A D, Cianflone K. Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. Journal of Clinical Endocrinology and Metabolism.. 2003; 88 1594-1602
6 Holdstock C, Engstrom B E, Ohrvall M, Lind L, Sundmom M, Karlsson F A. Ghrelin and adipose tissue regulatory peptides: effect of gastric bypass surgery in obese humans. Journal of Clinical Endocrinology and Metabolism. 2003; 88 3177-3183
7 Hanusch-Enserer U, Brabant G, Roden M. Ghrelin concentrations in morbidly obese patients after adjustable gastric banding. New England Journal of Medicine. 2003; 348 2159-2160
8 Angrisani L, Furbetta F, Doldi S B, Basso N, Lucchese M, Giacomelli F, Zappa M, Di Cosmo L, Veneziani A, Turicchia G U, Alkilani M, Forestieri P, Lesti G, Puglisi F, Toppino M, Campanile F, Capizzi F D, D'Atri C, Sciptoni L, Giardiello C, Di Lorenzo N, Lacitignola S, Belvederesi N, Marzano B, Bernate P, Iuppa A, Borrelli V, Lorenzo M. Lap Band adjustable gastric banding system: the Italian experience with 1863 patients operated on 6 years. Surg Endosc. 2003; 17 (3) 409-412
9 Katz A, Nambi S S, Mather K, Baron A D, Follmann D A, Sullivan G. et al . Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. Journal of Clinical Endocrinology and Metabolism. 2000; 85 2402-2410
10 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostasis model assesment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia. 1985; 28 412-419
11 Haqq A M, Farooqi I S, O'Rahilly S, Stadler D D, Rosenfeld R G, Pratt K L. et al . Serum ghrelin levels are inversely correlated with body mass index, age, and insulin concentrations in normal children and are markedly increased in Prader-Willi syndrome. Journal of Clinical Endocrinology and Metabolism. 2003; 88 174-178
12 Shiiya T, Nakazato M, Mizuta M, Date Y, Mondal M S, Tanaka M. et al . Plasma Ghrelin Levels in Lean and Obese Humans and the Effect of Glucose on Ghrelin Secretion. Journal of Clinical Endocrinology and Metabolism. 2002; 87 240-244
13 Orio F Jr, Lucidi P, Palomba S, Tauchmanova L, Cascella T, Russo T. et al . Circulating ghrelin concentrations in the polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism. 2003; 88 942-945
14 Barazzoni R, Zanetti M, Stebel M, Biolo G, Cattin L, Guarnieri G. Hyperleptinemia prevents increased plasma ghrelin concentration during short-term moderate caloric restriction in rats. Gastroenterology. 2003; 124 1188-1192
15 Cummings D E, Foster K E. Ghrelin-leptin tango in body-weight regulation. Gastroenterology. 2003; 124 1532-1535
16 Nedvidkova J, Krykorkova I, Bartak V, Papezova H, Gold P W, Alesci S. et al . Loss of meal-induced decrease in plasma ghrelin levels in patients with anorexia nervosa. Journal of Clinical Endocrinology and Metabolism. 2003; 88 1678-1682

A. Bertoli,M. D.

Department of Internal Medicine, Università di Roma Tor Vergata

Via Montpellier 1 · 00133 Roma · Italy

Phone: +39(06)20902683

Fax: +39(06)20922679

Email: bertolia@rdn.it