ABSTRACT
Ghrelin is a peptide hormone with orexigenic properties that is produced by the stomach. Ghrelin and leptin are thought to be the main regulators of appetite and body weight. The present study was aimed at evaluating the effect of weight reduction after laparoscopic adjustable gastric banding (LAGB) on metabolic parameters and energy balance regulatory peptides. Patients were evaluated before and 6, 12, 24 or 36 months after the procedure, and a blood sample was obtained. Ghrelin rose 6 and 12 months after LABG, and then returned to near-baseline levels. In our study, the correlation between ghrelin and BMI was weak, but a strong significant correlation was maintained between leptin and BMI. We conclude that ghrelin is mainly stimulated by the negative caloric balance, and hypothesize that ghrelin is involved in maintaining a stable body weight, while leptin signals the body energy store; both hormones together are part of a more complex feedback mechanism.
Subject(s)
Gastroplasty , Laparoscopy , Obesity, Morbid/blood , Peptide Hormones/blood , Adult , Appetite/physiology , Body Mass Index , Body Weight/physiology , Female , Follow-Up Studies , Ghrelin , Hormones/blood , Humans , Insulin/blood , Insulin-Like Growth Factor I/metabolism , Leptin/blood , Male , Time FactorsABSTRACT
Morbid obesity is frequently associated with other characteristics of metabolic syndrome and is related to an increased risk of cardiovascular disease. This study aimed at evaluating time-course changes in body weight, body mass index (BMI), insulin sensitivity indexes and lipid profile in severely obese patients who underwent adjustable silicone gastric banding. We studied 19 obese subjects before and 6-36 months after surgery. An oral glucose tolerance test was performed in all non-diabetic patients. All subjects were evaluated using insulin sensitivity indexes (ISI-HOMA and QUICKI), lipid profile, and anthropometric parameters (WHR, WC, BMI), and body composition was assessed with bioelectrical impedance analysis (BIA). Most of the weight reduction occurred within the first 6-12 months, followed by near stabilisation or even weight regain. We found a significant decrease in fasting insulin, improvement in waist-hip ratio, reduction in BMI and fat mass percent. We observed an improvement in insulin sensitivity evaluated by means of ISI-HOMA and QUICKI. Bariatric surgery was an effective therapeutic approach for these obese patients because it reduced both weight and insulin resistance, along with improving metabolic parameters. Improvement in metabolic parameters appears to precede body weight reduction.
