Plasma ghrelin in obesity before and after weight loss after laparoscopical adjustable gastric banding.
Weight reduction after gastric bypass surgery has been attributed to a decrease of the orexigenic peptide ghrelin, which may be regulated by insulin and leptin. This study examined effects of long-term weight loss after laparoscopical adjustable gastric banding on plasma ghrelin and leptin concentrations and their relationship with insulin action. Severely obese patients (15 women, three men, 36 +/- 12 yr) underwent clinical examinations every 3 months and modified oral glucose tolerance tests to assess parameters of insulin sensitivity and secretion every 6 months. After surgery, body mass index fell from 45.3 +/- 5.3 to 37.2 +/- 5.3 and 33.6 +/- 5.5 kg/m(2) at 6 and 12 months, respectively (P < 0.0001). This was associated with lower (P < 0.0001) plasma glucose, insulin, insulin resistance, waist circumference, and blood pressure. Plasma leptin decreased from 27.6 +/- 9.5 to 17.7 +/- 9.8 (P = 0.0005) and 12.7 +/- 5.1 ng/ml (P < 0.0001). Plasma ghrelin was comparable before and at 6 months (234 +/- 53; 232 +/- 53 pmol/liter) but increased at 12 months (261 +/- 72 pmol/liter; P = 0.05 vs. 6 months). At 6 and 12 months, ghrelin levels correlated negatively with fasting plasma insulin levels and hepatic insulin extraction but not with body mass or insulin action. In conclusion, prolonged weight loss results in a rise of fasting ghrelin concentrations that correlates with fasting insulin concentrations but not improvement of insulin sensitivity.
Hanusch-Enserer
Ursula
U
Department of Internal Medicine, Wilhelminspital, A-1160 Vienna, Austria.
Cauza
Edmund
E
Brabant
Georg
G
Dunky
Attila
A
Rosen
Harald
H
Pacini
Giovanni
G
Tüchler
Heinz
H
Prager
Rudolf
R
Roden
Michael
M
D000328:Adult; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty; D054439:Ghrelin; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006728:Hormones / Q000097:blood; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008099:Liver / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery*; D009994:Osmolar Concentration; D036361:Peptide Hormones / Q000097:blood*; D011184:Postoperative Period; D015431:Weight Loss
D054439:Ghrelin; D006728:Hormones; D007328:Insulin; D020738:Leptin; D036361:Peptide Hormones