title: The effect of laparoscopic gastric banding surgery on plasma levels of appetite-control, insulinotropic, and digestive hormones.
abstract: BACKGROUND
  We hypothesized that laparoscopic adjustable gastric banding (LAGB) reduces weight and modulates ghrelin production, but largely spares gastrointestinal endocrine function. To examine this hypothesis, we determined plasma concentrations of appetite-control, insulinotropic, and digestive hormones in relation to LAGB.
  
  
  METHODS
  Twenty-four patients undergoing LAGB were prospectively enrolled. Body mass index (BMI) was measured and blood samples obtained at baseline and 6 and 12 months post-surgery. Plasma concentrations of leptin, acylated and total ghrelin, pancreatic polypeptide (PP), insulin, glucose-dependent insulinotropic peptide (GIP), active glucagon-like peptide-1 (GLP-1), gastrin, and pepsinogens I and II were measured using enzyme-linked immunoassays.
  
  
  RESULTS
  Median percent excess weight loss (%EWL) over 12 months was 45.7% with median BMI decreasing from 43.2 at baseline to 33.8 at 12 months post-surgery (p < 0.001). Median leptin levels decreased from 19.7 ng/ml at baseline to 6.9 ng/ml at 12 months post-surgery (p < 0.001). In contrast, plasma levels of acylated and total ghrelin, PP, insulin, GIP, GLP-1, gastrin, and pepsinogen I did not change in relation to surgery (p > 0.05). Pepsinogen II levels were significantly lower 6 months after LAGB but returned to baseline levels by 12 months.
  
  
  CONCLUSIONS
  LAGB yielded substantial %EWL and a proportional decrease in plasma leptin. Our results support the hypothesis that LAGB works in part by suppressing the rise in ghrelin that normally accompanies weight loss. Unchanged concentrations of insulinotropic and digestive hormones suggest that gastrointestinal endocrine function is largely maintained in the long term.
authors.affiliation: Department of Medicine, NYU School of Medicine, New York, NY, USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Shak
authors.forename: Jatin
authors.initials: J
authors.lastname: Roper
authors.forename: Guillermo I
authors.initials: GI
authors.lastname: Perez-Perez
authors.forename: Chi-hong
authors.initials: CH
authors.lastname: Tseng
authors.forename: Fritz
authors.initials: F
authors.lastname: Francois
authors.forename: Zoi
authors.initials: Z
authors.lastname: Gamagaris
authors.forename: Carlie
authors.initials: C
authors.lastname: Patterson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Weinshel
authors.forename: George A
authors.initials: GA
authors.lastname: Fielding
authors.forename: Christine
authors.initials: C
authors.lastname: Ren
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Blaser
mesh_terms: D000328:Adult; D001069:Appetite Regulation / Q000502:physiology; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005768:Gastrointestinal Hormones / Q000097:blood*; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery*; D036361:Peptide Hormones / Q000097:blood*; D011446:Prospective Studies; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology
chemical_list: D005768:Gastrointestinal Hormones; D036361:Peptide Hormones