title: Plasma ghrelin, leptin, and orexin-A levels and insulin resistance after laparoscopic gastric band applications in morbidly obese patients.
abstract: OBJECTIVE
  The main cause of obesity is a change in the energy balance in favor of intake. Communication between the hypothalamus and other organs occurs through special peptides, such as ghrelin, leptin, and orexin-A, to provide energy balance. The purpose of this study was to investigate the effects of a laparoscopic gastric band application on insulin resistance and the peptides involved in appetite in morbidly obese patients.
  
  
  METHODS
  The study group consisted of 20 patients who were operated on for morbid obesity (body mass index [BMI], 48.3±6.7 kg/m2) and the control group contained 20 healthy, normal-weight subjects (BMI, 22.6±2 kg/m2). We obtained blood samples from the study subjects before surgery and one month after surgery, and once from the control group. We measured plasma levels of ghrelin, leptin, orexin-A, and plasma glucose.
  
  
  RESULTS
  Significant weight loss was achieved after surgery (P<0.05). Plasma ghrelin levels were lower in morbidly obese patients (P=0.033), but increased postoperatively (P=0.014), compared with those in the control subjects. Leptin levels were higher in the morbidly obese group (P=0.000), but decreased after the operation (P=0.01). Orexin-A levels were higher in the morbidly obese group (P=0.000), but decreased after the operation (P=0.000). Insulin resistance values also decreased in a manner similar to leptin and orexin-A levels (P=0.000 and P=0.008, respectively).
  
  
  CONCLUSIONS
  Laparoscopic gastric band application results in significant weight loss in morbidly obesity patients, even after one month. We found a decrease in patient BMI, increased ghrelin levels, and decreased leptin and orexin-A levels and insulin resistance.
authors.affiliation: Department of General Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
authors.forename: P
authors.initials: P
authors.lastname: Cigdem Arica
authors.forename: A
authors.initials: A
authors.lastname: Kocael
authors.forename: O
authors.initials: O
authors.lastname: Tabak
authors.forename: M
authors.initials: M
authors.lastname: Taskin
authors.forename: K
authors.initials: K
authors.lastname: Zengin
authors.forename: H
authors.initials: H
authors.lastname: Uzun
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D054439:Ghrelin; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D047908:Intracellular Signaling Peptides and Proteins; D010535:Laparoscopy; D020738:Leptin / Q000097:blood; D008297:Male; D009479:Neuropeptides; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D000068797:Orexins; D015431:Weight Loss
chemical_list: D054439:Ghrelin; C000596229:HCRT protein, human; D047908:Intracellular Signaling Peptides and Proteins; D020738:Leptin; D009479:Neuropeptides; D000068797:Orexins