Disruption of the leptin-insulin relationship in obese men 24 hours after laparoscopic adjustable silicone gastric banding.
BACKGROUND
The placement of a band to attain a tiny stomach pouch has been reported to produce early satiety in patients undergoing gastric banding. The adipocyte-derived hormone, leptin, has been shown to decrease both food intake and body weight. The aim of the present study was to assess the potential involvement of acute changes in leptin concentrations following laparoscopic adjustable silicone gastric banding (LASGB).


METHODS
The study groups comprised obese male patients undergoing bariatric surgery by LASGB and overweight men undergoing laparoscopic Nissen fundoplication (NFd). Blood was drawn before surgery and 24 hours postoperatively for glucose, insulin and leptin measurements.


RESULTS
In both experimental groups, a statistically significant decrease was observed in pre- and postsurgery glucose (LASGB 111 +/- 8 vs 99 +/- 6 mg/dl, P < 0.01; NFd 107 +/- 7 vs 98 +/- 5 mg/d, P < 0.01) and insulin concentrations (LASGB 39.8 +/- 11.9 vs 32.9 +/- 10.3 U/l, P < 0.01; NFd 13.2 +/- 3.3 vs 12.2 +/- 2.9 U/l, P < 0.05). However, no significant differences were observed when the percent change from pre-surgery values was analysed between both groups. Following surgery, an increase in leptin concentrations was observed in the LASGB group (23.5 +/- 4.7 vs 37.5 +/- 6.8 micrograms/l, P < 0.001) whereas a small decrease was evident in the NFd patients (12.9 +/- 4.6 vs 8.9 +/- 2.2 micrograms/l, P < 0.01).


CONCLUSIONS
These findings strongly suggest that the short-term increase observed in plasma leptin concentrations following LASGB may play a key role in triggering an early satiety signal due to the modification of the gastrointestinal anatomy and physiology.
Frühbeck
Gema
G
Department of Endocrinology, Clínica Universitaria de Navarra, 31008, Pamplona, Spain. gfruhbeck@unav.es
Diez-Caballero
Alberto
A
Gómez-Ambrosi
Javier
J
Gil
María J
MJ
Monreal
Ignacio
I
Salvador
Javier
J
Cienfuegos
Javier A
JA
D000328:Adult; D001458:Bandages; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D018662:Fundoplication; D015391:Gastroplasty; D006801:Humans; D007328:Insulin / Q000097:blood*; D010535:Laparoscopy; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D012528:Satiety Response / Q000502:physiology; D012737:Sex Factors; D012828:Silicones / Q000627:therapeutic use*; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D012828:Silicones