Ghrelin and obestatin levels in severely obese women before and after weight loss after Roux-en-Y gastric bypass surgery.
BACKGROUND
Ghrelin and obestatin are derived from the same gene but have different effects: Ghrelin stimulates appetite, and previous-albeit inconsistent-data show that obestatin may be involved in satiety. The present study was designed to test the hypothesis that Roux-en-Y gastric bypass (RYGB) surgery and/or the weight loss that reliably results from this procedure would alter levels of ghrelin and obestatin and ghrelin/obestatin ratios in a cohort of morbidly obese women.


METHODS
This is a longitudinal follow-up study in 18 morbidly obese women (mean weight 131.2 kg, mean body mass index [BMI] 47.4). Clinical parameters and fasting serum concentrations of ghrelin, obestatin, triglycerides, low-density lipoprotein cholesterol, glucose, and insulin were measured before and 2 years after RYGB surgery, which was associated with body weight reductions of 41.5 +/- 11.6 kg (mean 62.5% excess weight loss).


RESULTS
Ghrelin concentrations (-12%, p = 0.022) and ghrelin/obestatin ratios (-14%, p = 0.017) were lower after surgery than before, while obestatin levels did not change. Changes in ghrelin concentrations correlated with changes in insulin levels (r = 0.45, p = 0.011). Most cardiovascular risk factors studied improved postsurgically (p < 0.01).


CONCLUSIONS
In contrast to previous weight loss studies involving gastric banding, ghrelin levels decreased and obestatin levels remained stable after massive weight loss in long-term follow-up. The favorable gastrointestinal hormone profiles observed are likely to contribute to the long-term weight loss success rate attributed to RYGB.
Seattle Children's Hospital Research Institute, 1900 Ninth Avenue, Seattle, WA, 98101, USA. christian.roth@seattlechildrens.org
Christian L
CL
Roth
Thomas
T
Reinehr
Gerit-Holger
GH
Schernthaner
Hans-Peter
HP
Kopp
Stefan
S
Kriwanek
Guntram
G
Schernthaner
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D010535:Laparoscopy; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications / Q000601:surgery*; D036361:Peptide Hormones / Q000097:blood*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
D001786:Blood Glucose; D054439:Ghrelin; D008055:Lipids; D036361:Peptide Hormones; C505799:obestatin, human