title: Plasma Ghrelin Levels and Weight Regain After Roux-en-Y Gastric Bypass Surgery.
abstract: Ghrelin is a gut hormone that induces hunger, gastric acid secretion, and gastrointestinal motility. A number of studies have previously demonstrated a possible correlation between a decrease in ghrelin level and weight loss after Roux-en-Y gastric bypass (RYGB). This study aimed to assess if there was a relationship between ghrelin level and weight regain after RYGB nadir weight had been achieved.
  
  
  
  Sixty-three consecutive RYGB patients who were referred for an upper endoscopy were enrolled. Weight and responses to the 21-item Three-Factor Eating Questionnaire (TFEQ-R21) were collected. Ghrelin levels were measured. Upper endoscopy was performed to evaluate pouch length and stoma diameter. Multivariate linear regression was performed to assess an association between ghrelin level, TFEQ-R21 score, pouch length, stoma diameter, and percentage of weight regained.
  
  
  
  Subjects were 47 ± 10 years old and had a BMI of 38 ± 7.7 kg/m2. Out of 63 patients, 76 % had weight regain (gaining of ≥20 % of maximal weight lost after the RYGB) and 24 % did not. Average pouch length was 44 ± 13 mm, stoma diameter 20 ± 6.6 mm, and ghrelin levels 125 ± 99 ng/ml. Ghrelin level was not associated with weight regain (β = 0.17, p = 0.2). GJ stoma diameter was associated with weight regain (β = 0.39, p < 0.01) and the uncontrolled eating domain of the TFEQ-R21 (β = 0.45, p < 0.01).
  
  
  
  Ghrelin levels do not appear to correlate with weight change after RYGB nadir weight has been achieved. A dilated GJ stoma diameter is a risk factor for weight regain and uncontrolled eating behavior after RYGB.
authors.affiliation: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.|Harvard Medical School, Boston, MA, USA.|Mayo Clinic, Rochester, MN, USA.
authors.forename: Barham K
authors.initials: BK
authors.lastname: Abu Dayyeh
authors.affiliation: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Pichamol
authors.initials: P
authors.lastname: Jirapinyo
authors.affiliation: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. cthompson@hms.harvard.edu.|Harvard Medical School, Boston, MA, USA. cthompson@hms.harvard.edu.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Thompson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005247:Feeding Behavior; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D005773:Gastroscopy; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012307:Risk Factors; D054047:Surgical Stomas; D015430:Weight Gain / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology
chemical_list: D015415:Biomarkers; D054439:Ghrelin
keywords: Endoscopy; Ghrelin; Obesity; RYGB; Stoma diameter; Weight regain