Morbidly Obese are Ghrelin and Leptin Hyporesponders with Lesser Intragastric Balloon Treatment Efficiency

Abstract

The importance of ghrelin and leptin in treatment-induced changes was reaffirmed. Ghrelin hyper-response in non-morbidly obese subjects characterized greater short-term treatment efficiency and landmarked an inclination to weight regain. The results suggest a potential pattern of individualization between obese patients according to body mass index towards intragastric balloon or bariatric surgery. Further studies are needed in order to get better insights in the pathophysiologic mechanisms of obesity.

The Role of Intragastric Balloon on EBL %, Homeostasis of Lipid and Satiety Hormone

“…The decline in plasma leptin levels was similarly reported in three studies with the introduction of the intragastric balloon in morbidly obese patients [14]. The concentration continued to fall at lesser marginal levels until the end of the study.…”

“…Biological effects of ghrelin appear to be the opposite of those of leptin, which has been suggested to be the key signal reflecting adipose stores [34].…”

“…Ghrelin stimulates both energy gain and the secretion of growth hormone (GH) and insulin leading to weight gain and attainment of a positive energetic balance in the long term [13]. In addition, Ghrelin levels seem to be influenced by age, gender, BMI, growth hormone, glucose, and insulin [14]. Leptin, a 167-amino acid protein produced by adipocytes in the hypothalamus is opposite to that of Ghrelin molecule [15].…”

Variation in blood levels of hormones in obese patients following weight reduction induced by endoscopic and surgical bariatric therapies

“…Several reports have described different plasma hormonal changes after bariatric surgery, but the data on the effect on the omentin and visfatin levels are sparse and conflicting [9][10][11][12][13][14][15][16][17]. Moreover, only a few studies have described hormonal changes, mainly ghrelin and leptin, after endoscopic placement of a balloon into the stomach (bioenterics intragastric balloon, BIB), which is a commonly used procedure, also as bridge therapy to surgery, due to its minimal invasiveness and good tolerability [18,19]. We recently found that in morbidly obese patients, weight reduction induced by BIB was connected with a decrease of leptin plasma levels and transient elevation of ghrelin levels, while the levels of these hormones remained relatively stable in obese patients treated with a low-calorie diet and physical effort [18].…”

Changes In Leptin Level After Different Bariatric Procedures: Gastric Balloon And Sleeve Gastrectomy, And Its Relation To The Effectiveness Of Weight Loss.

“…[11] The six months follow up duration is recommended in case of IGB but the regaining of weight is a common outcome on long term follow up of the patients [12].…”