Ghrelin, Leptin and Insulin Levels after Restrictive Surgery: a 2-Year Follow-up Study

Nijhuis, Jeroen; Dielen, François M. H. van; Buurman, Wim A.; Greve, Jan

doi:10.1381/0960892041590980

Cited by 92 publications

(66 citation statements)

References 20 publications

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“…Fasting ghrelin levels have been found to increase 2 years after vertical banded gastroplasty [38] and in patients who attained 20% body mass index (BMI) loss [39]. Likewise, in obese patients 6 months [9,16,18,19,40,41], 12 months [17,19,40], and 24 months [38,40] after being submitted to adjustable gastric banding, fasting ghrelin levels have been shown to increase, similarly to diet induced weight loss, although the increase in ghrelin levels was greater after surgery than after dietinduced weight loss, and this could be explained by the higher amount of weight loss achieved with surgery. Furthermore, postoperative ghrelin levels were also reported as not being different from those of non-operated BMImatched patients [9].…”

Section: Discussionmentioning

confidence: 99%

Increase in Ghrelin Levels After Weight Loss in Obese Zucker Rats is Prevented by Gastric Banding

et al. 2007

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Background Gastric banding is thought to decrease appetite in addition to the mechanical effects of food restriction, although this has been difficult to demonstrate in human studies. Our aim was to investigate the changes in orexigenic signals in the obese Zucker rat after gastric banding. Methods Obese Zucker rats ( fa/fa) were submitted to gastric banding (GBP), sham gastric banding fed ad libitum (sham), or sham operation with food restriction, pair-fed to the gastric banding group (sham-PF). Lean Zucker rats ( fa/+) were used as additional controls. Body weight and food intake were daily recorded for 21 days after surgery when epididymal fat was weighed and fasting ghrelin and hypothalamic NPY mRNA expression were measured. Results Gastric banding in obese Zucker rats resulted in a significant decrease of cumulative body weight gain and food intake. Furthermore, gastric banded rats were leaner than Sham-PF, as expressed by a significantly lower epididymal fat weight. Ghrelin levels of gastric banded rats were not increased when compared to sham-operated animals fed ad libitum and were significantly lower than the levels of weight matched sham-PF rats (1116.9±103.3 g GBP vs 963.2±54.3 g sham, 3,079.5±221.6 sham-PF and 2,969.9±150.9 g lean rats, p<0.001); hypothalamic NPY mRNA expression was not increased in GBP when compared to sham-operated rats. Conclusion In obese Zucker rats, GBP prevents the increase in orexigenic signals that occur during caloric deprivation. Our data support the hypothesis that sustained weight loss observed after gastric banding does not depend solely on food restriction.

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Section: Discussionmentioning

confidence: 99%

Increase in Ghrelin Levels After Weight Loss in Obese Zucker Rats is Prevented by Gastric Banding

et al. 2007

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“…However, the regulation and action of ghrelin, in relationship with other energy signals, is incompletely understood (Box 1). After dieting and restrictive bariatric procedures, fasting ghrelin levels increase in proportion to weight loss (42,70,95,135,141,185). Therefore, a profound elevation in fasting ghrelin might be anticipated following RYGB, which produces proportionately more weight loss.…”

Section: Mechanisms Of Weight Loss After Rygbmentioning

confidence: 99%

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

Scott

Batterham

2011

American Journal of Physiology-Regulatory, Integrative and Comp

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Obesity increases the likelihood of diseases like type 2 diabetes (T2D), heart disease, and cancer, and is one of the most serious public health problems of this century. In contrast to ineffectual prevention strategies, lifestyle modifications, and pharmacological therapies, bariatric surgery is a very effective treatment for morbid obesity and also markedly improves associated comorbidities like T2D. However, weight loss and resolution of T2D after bariatric surgery is heterogeneous and specific to type of bariatric procedure performed. Conventional mechanisms like intestinal malabsorption and gastric restriction do not fully explain this, and potent changes in appetite and the enteroinsular axis, as a result of anatomical reorganization and altered hormonal, neuronal, and nutrient signaling, are the portended cause. Uniquely these signaling changes appear to override vigorous homeostatic defenses of stable body weight and compelling self-gratifying motivations to eat and to reverse defects in beta-cell function and insulin sensitivity. Here we review mechanisms of weight loss and T2D resolution after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy bariatric surgery, two markedly different procedures with robust clinical outcomes.

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“…46 Most bariatric procedures have been associated with a significant decrease in leptin levels that persists for up to 2 years after surgery. 47 Although changes in leptin concentrations are correlated with changes in subcutaneous, visceral, and total adipose tissues, surgical modulation of this adipokine can be through both weight loss-dependent and -independent mechanisms. The latter can be multifactorial but may involve a postoperative association of leptin with insulin levels.…”

Section: Adipokines and Bariatric Surgerymentioning

confidence: 99%

Effects of Bariatric Surgery on Cardiovascular Function

et al. 2008

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Ghrelin, Leptin and Insulin Levels after Restrictive Surgery: a 2-Year Follow-up Study

Cited by 92 publications

References 20 publications

Increase in Ghrelin Levels After Weight Loss in Obese Zucker Rats is Prevented by Gastric Banding

Increase in Ghrelin Levels After Weight Loss in Obese Zucker Rats is Prevented by Gastric Banding

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

Effects of Bariatric Surgery on Cardiovascular Function

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