title: Effect of Laparoscopic Sleeve Gastrectomy on Fasting Gastrointestinal, Pancreatic, and Adipose-Derived Hormones and on Non-Esterified Fatty Acids.
abstract: Alterations in gastrointestinal, pancreatic, and adipose hormone levels may have a greater role in weight loss than initially appreciated. The laparoscopic sleeve gastrectomy (LSG) operation is now the most frequently performed bariatric operation in many countries, but there are relatively few data regarding its molecular effects. We sought to characterize the effect of LSG on fasting plasma levels of selected hormones and on non-esterified fatty acids (NEFA), and to compare these to levels in non-obese control individuals.
  
  
  
  The levels of nine plasma hormones were measured using a multiplex bead-based assay at baseline and at 3 months after operation in 11 obese patients undergoing LSG. NEFA levels were also measured. The levels were compared to those for 22 age- and sex-matched non-obese individuals.
  
  
  
  At baseline, obese patients showed significantly higher expression of C-peptide, insulin, and leptin and significantly lower ghrelin, glucose-dependent insulinotropic peptide (GIP), and resistin compared to non-obese controls (p < 0.05). LSG resulted in a reduction in BMI from 42.5 ± 6.47 kg/m2at operation to 35.2 ± 5.14 kg/m2at 3 months (42 % mean excess weight loss, p < 0.001). LSG led to a significant decrease in ghrelin, glucagon-like peptide-1 (GLP-1), glucagon, leptin, plasminogen activator inhibitor-1 (PAI-1), and NEFA.
  
  
  
  LSG induces marked early changes in the fasting levels of factors thought to be important regulators of obesity and metabolic health. These changes differ somewhat from the findings for operations with a malabsorptive component, suggesting that subtle differences exist in the mechanisms of weight loss between LSG and other bariatric operations.
authors.affiliation: Department of Surgery, School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia.|Gastro-oesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Suite 606, 438 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
authors.forename: John E
authors.initials: JE
authors.lastname: Farey
authors.affiliation: Department of Surgery, School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia.|Gastro-oesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Suite 606, 438 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
authors.forename: Tamara C
authors.initials: TC
authors.lastname: Preda
authors.affiliation: Department of Surgery, School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia.|Gastro-oesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Suite 606, 438 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
authors.forename: Oliver M
authors.initials: OM
authors.lastname: Fisher
authors.affiliation: Gastro-oesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Suite 606, 438 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
authors.forename: Angelique J
authors.initials: AJ
authors.lastname: Levert-Mignon
authors.affiliation: Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, Sydney, Australia.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Stewart
authors.affiliation: Biomolecular Frontiers Centre, Department of Chemistry and Biomolecular Science, Faculty of Science, Macquarie University, Sydney, Australia.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Karsten
authors.affiliation: Biomolecular Frontiers Centre, Department of Chemistry and Biomolecular Science, Faculty of Science, Macquarie University, Sydney, Australia.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Herbert
authors.affiliation: Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, Sydney, Australia.|School of Medical Sciences, UNSW, Sydney, NSW, Australia.|Centre for Diabetes, Obesity and Endocrinology, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Swarbrick
authors.affiliation: Department of Surgery, School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia. rvlord@stvincents.com.au.|Gastro-oesophageal Cancer Research Program, St Vincent's Centre for Applied Medical Research, Suite 606, 438 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia. rvlord@stvincents.com.au.
authors.forename: Reginald V
authors.initials: RV
authors.lastname: Lord
mesh_terms: D054392:Adipokines / Q000097:blood*; D050154:Adiposity; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005215:Fasting / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D005743:Gastrectomy / Q000379:methods / Q000534:rehabilitation; D005768:Gastrointestinal Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery*; D010187:Pancreatic Hormones / Q000097:blood*; D015431:Weight Loss
chemical_list: D054392:Adipokines; D005230:Fatty Acids, Nonesterified; D005768:Gastrointestinal Hormones; D010187:Pancreatic Hormones
keywords: Bariatric surgery; C-peptide; GIP; GLP-1; Ghrelin; Glucagon; Insulin; Leptin; NEFA; PAI-1; Resistin; Sleeve gastrectomy; Weight loss