title: Long-term changes in leptin, chemerin and ghrelin levels following different bariatric surgery procedures: Roux-en-Y gastric bypass and sleeve gastrectomy.
abstract: BACKGROUND
  Different studies have evaluated changes in adipo/cytokine levels after bariatric surgery and have given conflicting results. The adipo/cytokines, leptin and chemerin, and the orexigenic hormone, ghrelin, have been shown to play a role in the regulation of metabolism and appetite. The aims of our study were to test the levels of these molecules after bariatric surgery and to compare the results between Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy.
  
  
  METHODS
  We analysed circulating levels of chemerin, ghrelin and leptin in 30 morbidly obese women (body mass index of >40 kg/m2). Subjects were studied at three time points: baseline (before the surgery started), and after 6 and 12 months.
  
  
  RESULTS
  After surgery, chemerin (baseline, 95.03 ± 23.79; after 12 months, 76.80 ± 21.51; p = 0.034) and leptin levels (baseline, 248.17 ± 89.16; after 12 months, 63.85 ± 33.48; p < 0.001) were significantly lower than their baseline levels, whereas ghrelin was higher (baseline, 0.87 ± 0.38; after 12 months, 1.08 ± 0.31; p = 0.010). Fasting glucose, insulin and homeostasis model assessment of insulin resistance levels were markedly lower postoperatively. High-density lipoprotein levels moderately increased and triglyceride levels sharply decreased. There were no differences between the types of bariatric surgery in terms of weight reduction, general metabolic state or adipo/cytokine levels after surgery.
  
  
  CONCLUSIONS
  Our study demonstrates a marked decrease in fasting leptin and chemerin levels, and an increase in ghrelin levels, after bariatric surgery-induced weight loss, independently of the type of surgery performed. Further studies are needed on the interrelation between the changes in the circulating levels of these molecules and the efficacy of the bariatric surgery procedures to induce the beneficial metabolic changes and to sustain body weight loss.
authors.affiliation: Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain.
authors.forename: Ximena
authors.initials: X
authors.lastname: Terra
authors.forename: Teresa
authors.initials: T
authors.lastname: Auguet
authors.forename: Esther
authors.initials: E
authors.lastname: Guiu-Jurado
authors.forename: Alba
authors.initials: A
authors.lastname: Berlanga
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Orellana-Gavaldà
authors.forename: Mercè
authors.initials: M
authors.lastname: Hernández
authors.forename: Fàtima
authors.initials: F
authors.lastname: Sabench
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Porras
authors.forename: Jordi
authors.initials: J
authors.lastname: Llutart
authors.forename: Salomé
authors.initials: S
authors.lastname: Martinez
authors.forename: Carmen
authors.initials: C
authors.lastname: Aguilar
authors.forename: Daniel
authors.initials: D
authors.lastname: Del Castillo
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Richart
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D018925:Chemokines / Q000097:blood*; D005215:Fasting / Q000378:metabolism; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007333:Insulin Resistance; D036341:Intercellular Signaling Peptides and Proteins; D010535:Laparoscopy; D020738:Leptin / Q000097:blood*; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000453:epidemiology / Q000601:surgery*; D011184:Postoperative Period; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D018925:Chemokines; D054439:Ghrelin; D036341:Intercellular Signaling Peptides and Proteins; D020738:Leptin; C478630:RARRES2 protein, human