Serum ghrelin, leptin and adiponectin levels before and after weight loss: comparison of three methods of treatment--a prospective study.
BACKGROUND
Ghrelin is a peptide hormone with orexigenic properties, primarily produced by the stomach. Leptin and adiponectin are the two adiposity products that participate in body weight control. Leptin always decreases and adiponectin increases after weight loss. Different changes in fasting ghrelin levels have been reported following bariatric surgery. In this study, we compare the changes in fasting ghrelin, leptin and adiponectin levels in 3 groups of patients who achieved weight loss by either diet, MacLean vertical banded gastroplasty (VBG) or biliopancreatic diversion with duodenal switch (BPD-DS).


METHODS
Serum fasting ghrelin, leptin and adiponectin concentration was measured in 40 obese patients who achieved weight loss by either diet (n=14), VBG (n=13) or BPD-DS (n=13), before and after weight loss. The follow-up period was 18 months for BPD-DS and VBG and 6 months for diet. Serum ghrelin level was measured by ELISA.


RESULTS
BMI was significantly decreased in all 3 groups: 9.2+/-2.4% (P<0.01) following diet, 38.47+/-7.26% (P<0.01) after VBG, and 42.88+/-9.09% after BPD-DS (P<0.01). Serum fasting ghrelin level increased after diet (110.45+/-117.84%, P=0.002) and VBG (65.48+/-92.93%, P=0.001),but decreased after BPD-DS (-21.63+/-28.63%, P=0.019). Leptin concentration decreased and adiponectin increased in all groups.


CONCLUSIONS
Unlike after diet or gastric restrictive surgery, BPD-DS is associated with markedly suppressed ghrelin levels, possibly contributing to the weight-reducing effect of this operation. Sleeve gastrectomy seems to be the main cause of this reduction.
Kotidis
Efstathios V
EV
Aristotle University of Thessaloniki, AHEPA University Hospital-Third Department of Surgery, Thessaloniki, Greece.
Koliakos
George G
GG
Baltzopoulos
Vasilios G
VG
Ioannidis
Konstantinos N
KN
Yovos
John G
JG
Papavramidis
Spiros T
ST
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D015904:Biliopancreatic Diversion; D031204:Caloric Restriction; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D054439:Ghrelin; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000178:diet therapy / Q000601:surgery; D036361:Peptide Hormones / Q000097:blood*; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology*
D052242:Adiponectin; D054439:Ghrelin; D020738:Leptin; D036361:Peptide Hormones