title: Effects of laparoscopic gastric band applications on plasma and fundic acylated ghrelin levels in morbidly obese patients.
abstract: BACKGROUND
  It has been proposed that laparoscopic adjustable gastric banding (LAGB) procedure might play a role in modulation of fundic ghrelin production. To test this hypothesis, we examined plasma and tissue concentrations of acylated ghrelin in morbidly obese patients before and 6 months after LAGB. Baseline levels of acylated ghrelin in morbidly obese patients were also compared with those in age-matched, healthy, non-obese controls.
  
  
  METHODS
  We studied 21 patients who had been operated on for morbid obesity (M/F = 9/12, BMI = 49.3 ± 5.3 kg/m(2)) and 16 healthy, non-obese persons (M/F = 7/9, BMI = 23.0 ± 1.7 kg/m(2)). Fasting blood samples were collected once from the non-obese controls as well as the morbidly obese patients before and 6 months after the LAGB. The morbidly obese patients and their respective controls underwent gastroscopy for fundic biopsy. The plasma and fundic acylated ghrelin levels were evaluated in these groups by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The plasma and fundic acylated ghrelin concentrations were significantly lower in obese patients than in non-obese controls (2.8 ± 1.0 ng/ml, 727 ± 171.7 ng/g tissue, respectively; p = 0.000). These parameters were significantly increased in morbidly obese patients 6 months after LAGB (4.1 ± 1.2 ng/ml and p = 0.001; 999 ± 292.1 ng/g tissue and p = 0.003, respectively).
  
  
  CONCLUSIONS
  We showed that fundic production of acylated ghrelin was significantly increased in morbidly obese patients 6 months after LAGB. Moreover, the weight loss after LAGB occurred in spite of the significant increase in the plasma and fundic acylated ghrelin levels. The potential role of ghrelin as being responsible for the weight loss after bariatric surgery needs to be elucidated in further studies.
authors.affiliation: Department of Biochemistry, Cerrahpasa Medical Faculty, Istanbul University, 34303 Cerrahpasa, Istanbul, Turkey. remisagelisgen@hotmail.com
authors.forename: Remise
authors.initials: R
authors.lastname: Gelisgen
authors.forename: Kagan
authors.initials: K
authors.lastname: Zengin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kocael
authors.forename: Birol
authors.initials: B
authors.lastname: Baysal
authors.forename: Pinar
authors.initials: P
authors.lastname: Kocael
authors.forename: Hayriye
authors.initials: H
authors.lastname: Erman
authors.forename: Mustafa
authors.initials: M
authors.lastname: Taskın
authors.forename: Hafize
authors.initials: H
authors.lastname: Uzun
mesh_terms: D000215:Acylation; D000328:Adult; D015992:Body Mass Index; D004797:Enzyme-Linked Immunosorbent Assay; D005215:Fasting; D005247:Feeding Behavior; D005260:Female; D015391:Gastroplasty / Q000379:methods; D054439:Ghrelin / Q000097:blood / Q000378:metabolism*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000378:metabolism* / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D054439:Ghrelin