Intragastric balloon-induced satiety is not mediated by modification in fasting or postprandial plasma ghrelin levels in morbid obesity.
BACKGROUND
The BioEnterics Intragastric Balloon (BIB) has been proposed as an adjuvant therapy for the short-term treatment of obesity. The temporal pattern of BIB-induced satiety and whether this effect is mediated by modification of ghrelin levels is unknown.


METHODS
Patients with treatment-resistant morbid obesity were invited to participate in a randomized, double-blind, sham-controlled trial of 4-month duration. Anthropometric and biochemical parameters, estimation of energy intake, and pre- and postprandial evaluation of satiety were required monthly. Ghrelin response after a standard mixed meal was scheduled prior to and 4 weeks after the endoscopic procedure.


RESULTS
21 out of 22 enrolled patients completed the study (17 women, 5 men; 35.9 +/- 9.9 years; BMI 50.4 +/- 7.8 kg/m2). Pre-intervention weight decreased from 143.8 +/- 31.2 kg to 131.1 +/- 32.6 kg in Group Balloon (P < 0.001) and from 138.8 +/- 24.5 kg to 129.9 +/- 25.6 kg in Group Sham (P < 0.01) at the end of the study. Weight loss was not significantly different in Group Balloon and Group Sham at any time-point of the follow-up. Only patients from Group Balloon showed a temporary increased pre- and postprandial satiety, which was maximal at 4 weeks after the intervention. Total area under the curve, fasting and postprandial plasma ghrelin were not significantly different between groups at inclusion or 4 weeks after follow-up. No correlation was found between any of the satiety scores at any time-point with their comparable ghrelin levels.


CONCLUSIONS
BIB induces a temporary sense of satiety in morbidly obese patients which is not mediated by modification of fasting or postprandial levels of plasma ghrelin.
Department of Endocrinology and Nutrition, University Hospital Virgen del Rocio, Seville, Spain.
Maria Asuncion
MA
Martinez-Brocca
Ovidio
O
Belda
Juana
J
Parejo
Luis
L
Jimenez
Agustin
A
del Valle
Jose Luis
JL
Pereira
Felipe
F
Garcia-Pesquera
Ricardo
R
Astorga
Alfonso
A
Leal-Cerro
Pedro Pablo
PP
Garcia-Luna
D000328:Adult; D004311:Double-Blind Method; D005215:Fasting / Q000502:physiology; D005260:Female; D015905:Gastric Balloon; D054439:Ghrelin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000523:psychology / Q000628:therapy*; D036361:Peptide Hormones / Q000097:blood*; D019518:Postprandial Period / Q000502:physiology; D012528:Satiety Response / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
D054439:Ghrelin; D036361:Peptide Hormones