Adami Gian Franco, Cordera Renzo, Andraghetti Gabriella, Camerini Giovanni B, Marinari Giuseppe M, Scopinaro Nicola
Dipartimento di Discipline Chirurgiche, Genova, Italy.
Obes Res. 2004 Apr;12(4):684-7. doi: 10.1038/oby.2004.79.
Ghrelin is a recently discovered hormone that is produced mainly by the stomach and that increases food intake in rodents and humans. It has been postulated that the weight loss after gastric bypass surgery for obesity might be related to changes in serum ghrelin concentration.
Serum leptin and ghrelin concentrations were measured in a group of obese patients before biliopancreatic diversion (BPD) and 2 and 12 months postoperatively. Insulin sensitivity was determined from serum glucose and insulin levels according to the homeostatic model of assessment for insulin resistance (HOMA IR).
A sharp drop was observed in body weight, in BMI values, in HOMA IR data, and in serum leptin concentration at 2 and 12 months after BPD, whereas a significant increase of serum ghrelin level was observed at 12 months, when food intake had returned to preoperative levels. A negative correlation between the postoperative changes of serum ghrelin concentration and those of HOMA IR values was observed at 2 and 12 months after BPD.
No evidence upholding a relationship between serum ghrelin concentration and food intake after BPD was seen; the postoperative changes likely reflected the achievement of a new state of energy balance. The negative relationship observed between post-BPD changes in HOMA IR values and changes in serum ghrelin concentration supported the role of insulin in the modulation of ghrelin production.
胃饥饿素是一种最近发现的激素，主要由胃产生，可增加啮齿动物和人类的食物摄入量。据推测，肥胖症患者接受胃旁路手术后体重减轻可能与血清胃饥饿素浓度的变化有关。
对一组肥胖患者在进行胆胰分流术（BPD）前、术后2个月和12个月时测量血清瘦素和胃饥饿素浓度。根据胰岛素抵抗稳态模型评估（HOMA-IR），从血清葡萄糖和胰岛素水平确定胰岛素敏感性。
在BPD术后2个月和12个月时，观察到体重、BMI值、HOMA-IR数据和血清瘦素浓度急剧下降，而在术后12个月，当食物摄入量恢复到术前水平时，血清胃饥饿素水平显著升高。在BPD术后2个月和12个月时，观察到血清胃饥饿素浓度的术后变化与HOMA-IR值的变化呈负相关。
未发现支持BPD术后血清胃饥饿素浓度与食物摄入量之间存在关系的证据；术后变化可能反映了新的能量平衡状态的实现。BPD术后HOMA-IR值变化与血清胃饥饿素浓度变化之间的负相关支持了胰岛素在调节胃饥饿素产生中的作用。
