Gastric pacing for morbid obesity: plasma levels of gastrointestinal peptides and leptin.
OBJECTIVE
A gastric pacemaker has been developed to treat morbid obesity. Patients experience increased satiety, the ability to reduce food intake, and a resultant weight loss. However, the mechanism behind the changed eating behavior in paced patients is still under investigation.


METHODS
This study was performed on 11 morbidly obese patients (mean BMI, 46.0 kg/m2) treated with gastric pacing. The peripheral blood levels of satiety signals of cholecystokinin (CCK), somatostatin, glucagon-like peptide-1 (GLP-1), and leptin were studied 1 month before gastric pacer implantation, 1 month after implantation, and 6 months after activation of electrical stimulation. Blood samples were drawn 12 hours after fasting and in response to a hypocaloric meal (270 kcal). Patients were followed monthly for vital signs and weight level.


RESULTS
Gastric pacing resulted in a significant weight loss of a mean of 10.4 kg (4.4 BMI units). No negative side effects or complications were observed during the treatment. After activation of the pacemaker, meal-related response of CCK and somatostatin and basal levels of GLP-1 and leptin were significantly reduced (p < 0.05) compared with the tests before gastric pacing. The weight loss correlated significantly with a decrease of leptin levels (R = 0.79, p < 0.01).


CONCLUSIONS
Gastric pacing is a novel and promising therapy for morbid obesity. Activation of the gastric pacer was associated with a decrease in plasma levels of CCK, somatostatin, GLP-1, and leptin. More studies are necessary to elucidate the correlations between satiety, weight loss, and digestive neuro-hormone changes.
Cigaina
Valerio
V
Unit of Digestive Electrophysiology and Obesity, Venice Hospital, Venice, Italy. valerio.cigaina@gastricpacer.com
Hirschberg
Angelica L
AL
D000328:Adult; D002766:Cholecystokinin / Q000097:blood; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005768:Gastrointestinal Hormones / Q000097:blood*; D052216:Glucagon-Like Peptide 1; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000628:therapy*; D010455:Peptides / Q000097:blood; D012527:Satiation; D013004:Somatostatin / Q000097:blood; D013270:Stomach / Q000502:physiology*; D015431:Weight Loss
D005768:Gastrointestinal Hormones; D020738:Leptin; D010455:Peptides; D013004:Somatostatin; D052216:Glucagon-Like Peptide 1; D002766:Cholecystokinin