Leonetti Frida, Silecchia Gianfranco, Iacobellis Gianluca, Ribaudo Maria Cristina, Zappaterreno Alessandra, Tiberti Claudio, Iannucci Concetta Valeria, Perrotta Nicola, Bacci Vincenzo, Basso Maria Sole, Basso Nicola, Di Mario Umberto
Division of Endocrinology, University La Sapienza, Rome, Italy 00161.
J Clin Endocrinol Metab. 2003 Sep;88(9):4227-31. doi: 10.1210/jc.2003-030133.
Gastric bypass has been reported to be associated with markedly suppressed plasma ghrelin levels, suggesting that it is one of the possible weight-reducing factors related to this procedure. The aim of this study was the evaluation of plasma ghrelin levels in patients who had undergone laparoscopic Roux-en-Y gastric bypass (LRYGBP) and laparoscopic adjustable silicone gastric banding (LASGB). Normoweight, obese subjects and patients who had undergone total gastrectomy were used as controls. In this cross-sectional study, we selected 10 subjects who underwent LASGB, 11 subjects with LRYGBP, 10 obese subjects, eight patients with total gastrectomy, and eight normoweight subjects. Plasma ghrelin, insulin, and glucose profiles were determined before and after breakfast and lunch. Obese subjects showed a ghrelin plasma level significantly lower than normoweight subjects (407.3 +/- 21.6 vs. 813 +/- 72.4 pg/ml, P < 0.01). Patients with LRYGBP showed baseline ghrelin levels lower than LASGB (213.5 +/- 73.9 vs. 314.2 +/- 84.3 pg/ml, P = 0.04). Both groups of patients who underwent bariatric surgical procedures also had ghrelin lower than normoweight and obese subjects (P < 0.01 and P < 0.05, respectively). Patients with total gastrectomy showed plasmatic ghrelin levels extremely lower than those in all other groups (32.6 +/- 18.7 pg/ml, P < 0.001 for all). The ghrelin profile in both groups of subjects who underwent LRYGBP and LASGB did not show any meal-related changes as observed in obese and normoweight control groups. Significant difference in plasma ghrelin levels between LRYGBP and LASGB was found, suggesting that both procedures could induce weight loss by different mechanisms in which ghrelin could be involved.
据报道，胃旁路手术与血浆胃饥饿素水平显著降低有关，这表明它是与该手术相关的可能的减肥因素之一。本研究的目的是评估接受腹腔镜Roux-en-Y胃旁路手术（LRYGBP）和腹腔镜可调节硅胶胃束带术（LASGB）的患者的血浆胃饥饿素水平。体重正常者、肥胖受试者和接受全胃切除术的患者作为对照。在这项横断面研究中，我们选取了10例接受LASGB的受试者、11例接受LRYGBP的受试者、10例肥胖受试者、8例接受全胃切除术的患者和8例体重正常的受试者。在早餐和午餐前后测定血浆胃饥饿素、胰岛素和葡萄糖水平。肥胖受试者的血浆胃饥饿素水平显著低于体重正常者（407.3±21.6对813±72.4 pg/ml，P<0.01）。接受LRYGBP的患者基线胃饥饿素水平低于接受LASGB的患者（213.5±73.9对314.2±84.3 pg/ml，P = 0.04）。两组接受减肥手术的患者的胃饥饿素水平也低于体重正常者和肥胖受试者（分别为P<0.01和P<0.05）。接受全胃切除术的患者血浆胃饥饿素水平极低，低于所有其他组（32.6±18.7 pg/ml，与所有其他组相比P<0.001）。接受LRYGBP和LASGB的两组受试者的胃饥饿素水平变化与肥胖和体重正常对照组中观察到的与进餐相关的变化不同。LRYGBP和LASGB之间血浆胃饥饿素水平存在显著差异，这表明两种手术可能通过胃饥饿素参与的不同机制导致体重减轻。
