title: Impact of sustained weight loss achieved through Roux-en-Y gastric bypass or a lifestyle intervention on ghrelin, obestatin, and ghrelin/obestatin ratio in morbidly obese patients.
abstract: BACKGROUND
  Appetite-regulating hormones seem to play an important role in weight loss after bariatric surgery. Less is known regarding long-term weight loss maintenance. The objective of the study was to evaluate ghrelin and obestatin levels following long-term weight loss achieved through bariatric surgery or a lifestyle intervention in morbidly obese patients.
  
  
  METHODS
  The study was cross-sectional in design carried out in a university research center setting. The participants were weight-stable morbidly obese patients who had undergone, on average, 3 years ago, Roux-en-Y gastric bypass (RYGB) surgery (n=9) or a lifestyle weight loss intervention (n=8), and patients on a waiting list for bariatric surgery (control group; n=9). The main outcome measures were fasting/postprandial plasma levels of total ghrelin and obestatin and ghrelin/obestatin ratio.
  
  
  RESULTS
  Fasting ghrelin and obestatin plasma levels were significantly elevated in the RYGB, but not in the lifestyle group, as compared with the control group. There was no statistical significant difference in fasting ghrelin/obestatin ratio among study groups. Ghrelin levels were suppressed after breakfast in all groups, with no significant differences in postprandial levels overtime between them. Obestatin levels did not change postprandially in any of the groups, but the area under the curve was significantly higher in the RYGB than in the control group.
  
  
  CONCLUSIONS
  Sustained weight loss maintenance seems to be associated with increased fasting levels of ghrelin and obestatin after RYGB surgery, but not after a lifestyle intervention, while maintaining ghrelin/obestatin ratio. Ghrelin is, therefore, unlikely to contribute to weight loss maintenance after RYGB, and other mechanisms are probably involved.
authors.affiliation: Faculty of Medicine, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. catia.martins@ntnu.no
authors.forename: Catia
authors.initials: C
authors.lastname: Martins
authors.forename: Louise
authors.initials: L
authors.lastname: Kjelstrup
authors.forename: Ingrid L
authors.initials: IL
authors.lastname: Mostad
authors.forename: Bård
authors.initials: B
authors.lastname: Kulseng
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D015390:Gastric Bypass; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000628:therapy; D015431:Weight Loss / Q000502:physiology*
chemical_list: D054439:Ghrelin; C505799:obestatin, human