Vertical banded gastroplasty modifies plasma ghrelin secretion in obese patients.
BACKGROUND
Restrictive bariatric surgery causes weight loss through substantial decline of appetite with satiety after meals. Reduction of plasma ghrelin levels after Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding could contribute to these effects, although contradictory results have been reported. The only restrictive operation still not yet investigated is vertical banded gastroplasty (VBG). We studied the effects of VBG on basal plasma ghrelin levels and meal-mediated inhibition.


METHODS
12 morbidly obese patients, 11 female and 1 male, were studied before and after VBG, when the BMI fell by 20%. The control group consisted of 6 lean volunteers. Active ghrelin was determined by RIA after overnight fasting and after the administration of a liquid meal.


RESULTS
Obese patients preoperatively had significantly lower basal plasma ghrelin levels than lean volunteers, and the meal did not inhibit ghrelin secretion. After VBG and 20% BMI loss, basal plasma ghrelin levels increased and the reduction caused by a meal recovered.


CONCLUSIONS
Weight loss caused by VBG is associated with higher plasma ghrelin levels in obese patients. The operation restores the normal adaptation of the A- cells of the stomach to a meal.
Foschi
D
D
Department of Surgery, S. Siro Clinical Institute, L. Sacco Hospital University of Milan, Milan, Italy. Diego.Foschi@unimi.it
Corsi
F
F
Rizzi
A
A
Asti
E
E
Carsenzuola
V
V
Vago
T
T
Bevilacqua
M
M
Riva
P
P
Trabucchi
E
E
D000328:Adult; D031204:Caloric Restriction; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D054439:Ghrelin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D036361:Peptide Hormones / Q000097:blood*; D015431:Weight Loss / Q000502:physiology
D054439:Ghrelin; D036361:Peptide Hormones