title: Changes in metabolic hormones after bariatric surgery and their predictive impact on weight loss.
abstract: BACKGROUND
  Although various metabolic hormones have been implicated in bariatric-related weight loss, their use as predictors of weight loss is unknown. Our study evaluates changes in metabolic hormones after bariatric surgery, and their role as predictors of weight loss.
  
  
  METHODS
  This nonrandomized study included 51 patients, 21 underwent laporascopic adjustable gastric banding (LAGB), 15 laparoscopic sleeve gastrectomy (LSG) and 15 Roux-en Y gastric bypass (RYGB). Serum ghrelin, leptin, insulin, growth hormone, HOMA-IR and HOMA-β was recorded at baseline and 1, 3, 6 and 12 months, and correlated with weight loss. Successful weight loss was defined as excess weight loss >50% at 12 months for all groups.
  
  
  RESULTS
  Weight loss pattern was similar in all groups. Ghrelin increased only in the LAGB group (P = 0·016). However, baseline ghrelin concentrations >664·6 pg/mL in the LSG group predicted successful weight loss with 81·8% sensitivity and 100·0% specificity, and ghrelin >969·8 pg/mL in the 1st postoperative month predicted success with 83·3% sensitivity and 83·3% specificity in the LAGB group. Insulin and HOMA-IR decreased significantly in the LSG and RYGB group, HOMA-β increased in the LAGB and LSG group. Serum leptin decreased and GH increased in all groups (P < 0·001 for all changes). Changes in insulin, leptin and growth hormone were not predictors, but a consequence of weight loss.
  
  
  CONCLUSIONS
  LSG is the most effective procedure for improvement of beta-cell function. High baseline ghrelin in the LSG group and an adequate 1st month increase in the LAGB group are associated with greater weight loss. Validation studies are required to confirm the role of ghrelin in predicting weight loss after bariatric surgery, but also in selecting candidates for specific bariatric procedures.
authors.affiliation: Department of Endocrinology, Diabetology and Metabolic diseases "Mladen Sekso", University Hospital Center "Sestre milosrdnice", University of Zagreb School of Medicine, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Kruljac
authors.affiliation: Department of Endocrinology, Diabetology and Metabolic diseases "Mladen Sekso", University Hospital Center "Sestre milosrdnice", University of Zagreb School of Medicine, Zagreb, Croatia.
authors.forename: Gorana
authors.initials: G
authors.lastname: Mirošević
authors.affiliation: Department of Endocrinology, Diabetology and Metabolic diseases "Mladen Sekso", University Hospital Center "Sestre milosrdnice", University of Zagreb School of Medicine, Zagreb, Croatia.
authors.forename: Lora S
authors.initials: LS
authors.lastname: Kirigin
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Center "Sestre milosrdnice", University of Zagreb School of Medicine, University of Zagreb School of Dental Medicine, Zagreb, Croatia.
authors.forename: Marko
authors.initials: M
authors.lastname: Nikolić
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Center "Sestre milosrdnice", University of Zagreb School of Medicine, University of Zagreb School of Dental Medicine, Zagreb, Croatia.
authors.forename: Neven
authors.initials: N
authors.lastname: Ljubičić
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital Center "Sestre milosrdnice", University of Zagreb School of Medicine, University of Zagreb School of Dental Medicine, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Budimir
authors.affiliation: Department of Abdominal Surgery, University Hospital Center "Sestre milosrdnice", University of Zagreb School of Dental Medicine, Zagreb, Croatia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Bekavac Bešlin
authors.affiliation: Department of Endocrinology, Diabetology and Metabolic diseases "Mladen Sekso", University Hospital Center "Sestre milosrdnice", University of Zagreb School of Medicine, Zagreb, Croatia.
authors.forename: Milan
authors.initials: M
authors.lastname: Vrkljan
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D005260:Female; D054439:Ghrelin / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D015431:Weight Loss
chemical_list: D054439:Ghrelin